Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 022466 | NY |
NPI | 1003313941 |
---|---|
Provider Name | Jaclyn Zocca |
First Address | Jersey City, NJ 07302-7011 |
Second Address | New York, NY 10032-3724 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2018 |
Last Update Date | 08/04/2018 |