Individual
JESSICA IACONO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
36 WASHINGTON AVE APT 447, CARTERET, NJ 07008-2778
(646) 492-0341
Mailing address
684 CRAIG AVE, STATEN ISLAND, NY 10307-1508
(646) 492-0341
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
35SI00738100
NJ
Other
Enumeration date
10/28/2020
Last updated
04/17/2024
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