Healthcare Provider Details

I. General information

NPI: 1518303668
Provider Name (Legal Business Name): JESSICA OKKEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2013
Last Update Date: 05/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

97 W PARKWAY
POMPTON PLAINS NJ
07444-1647
US

IV. Provider business mailing address

28 SLEEPY HOLLOW DR
OAK RIDGE NJ
07438-9351
US

V. Phone/Fax

Practice location:
  • Phone: 973-831-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number41YS00590600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: