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Organization

JACQUELINE A RONDEAU PSYD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JACQUELINE ANN RONDEAU PSYD (CLINICAL DIRECTOR)
(973) 743-4555
Entity
Organization

Contact information

Practice address
70 PARK ST, SUITE 207, MONTCLAIR, NJ 07042-5907
(973) 743-4555
(973) 743-4055
Mailing address
375 BELLEVILLE AVE, BLOOMFIELD, NJ 07003-2634
(973) 743-4555
(973) 743-4055

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
35SI00390000
NJ
103TC0700X
Clinical Psychologist
35SI00390000
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0051560
NJ
Enumeration date
05/05/2015
Last updated
05/05/2015
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