Individual
JESSICA CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
700 AIRPORT RD, LAKEWOOD, NJ 08701-5907
(732) 347-4700
Mailing address
700 AIRPORT RD, LAKEWOOD, NJ 08701-5907
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0029807
—
NJ
Enumeration date
06/02/2021
Last updated
06/02/2021
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