Jacqueline Matacchiera
Counselor, Professional in Mountain Lakes, NJ. Individual provider (NPI-1).
NPI number1669957080
StatusActive
Last updated in NPPESOct 2, 2018
Details
- NPI
- 1669957080
- Entity type
- Individual (NPI-1)
- Name
- Jacqueline Matacchiera
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 2, 2018
- Last updated
- Oct 2, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 37PC00585900 | NJ | Yes |
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | 37LC00279900 | NJ |
Practice location
420 Boulevard Ste 101Mountain Lakes, NJ 07046-1733
Phone 973-988-0035
Mailing address
40 Gates PlWayne, NJ 07470-3217
Phone 201-724-1190
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