Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 37PC00619400 | NJ |
NPI | 1003388042 |
---|---|
Provider Name | Jennifer Pearson |
First Address | Berlin, NJ 08009-9631 |
Second Address | Cherry Hill, NJ 08003-4217 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/12/2018 |
Last Update Date | 31/12/2018 |