Healthcare Provider Details

I. General information

NPI: 1619749843
Provider Name (Legal Business Name): MRS. JALEA COX
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2023
Last Update Date: 10/23/2023
Certification Date: 10/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 CHAPEL AVE W
CHERRY HILL NJ
08002-2048
US

IV. Provider business mailing address

4490 BERNARD RD
NEWFIELD NJ
08344-9100
US

V. Phone/Fax

Practice location:
  • Phone: 856-428-4357
  • Fax:
Mailing address:
  • Phone: 856-449-7230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: