Provider Information for 1396491221
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JENNIFER RUSSELL JARMARK LPC
Sex: Female
NPI: 1396491221
Last Updated: 2022-03-01
Certification Date: 2022-03-01
Certification Date: 2022-03-01
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1396491221 | ||||||||
| Enumeration Date | 2022-03-01 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 5 OAK RD SADDLE RIVER, NJ 07458-3011 United States Phone: 315-559-2853 | Fax: | ||||||||
| Primary Practice Address | 5 OAK RD SADDLE RIVER, NJ 07458-3011 United States Phone: 315-559-2853 | Fax: | ||||||||
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