Individual
MS. JILL NYDAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
30 DEER RUN LN, BRICK, NJ 08724-4390
(848) 448-0416
Mailing address
30 DEER RUN LN, BRICK, NJ 08724-4390
(848) 448-0416
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37PC00605100
NJ
Other
Enumeration date
05/06/2018
Last updated
05/06/2018
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