Individual
ELYCE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10 INDUSTRIAL WAY, EATONTOWN, NJ 07724
(732) 673-3183
Mailing address
175 E HAWTHORN PKWY STE 235, VERNON HILLS, IL 60061-1454
(847) 868-3435
(847) 859-5885
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
37AC00303100
NJ
Other
Enumeration date
02/01/2018
Last updated
03/10/2020
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