Individual
JESSICA CORCORAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
121 CHANLON RD, NEW PROVIDENCE, NJ 07974-1543
(973) 299-9954
Mailing address
22 WARREN AVE, HAWTHORNE, NJ 07506-2510
(201) 739-7058
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL06819600
NJ
Other
Enumeration date
05/13/2024
Last updated
05/13/2024
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