Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor |
NPI | 1053971853 |
---|---|
Provider Name | Jarrell Mclean |
First Address | Westampton, NJ 08060-3804 |
Second Address | Westampton, NJ 08060-3804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2019 |
Last Update Date | 14/06/2019 |