Healthcare Provider Details

I. General information

NPI: 1336014984
Provider Name (Legal Business Name): JODIE RENEE SESSOMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2025
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 W STATE ST BSMT 101
TRENTON NJ
08618-5664
US

IV. Provider business mailing address

407 W STATE ST BSMT 101
TRENTON NJ
08618-5664
US

V. Phone/Fax

Practice location:
  • Phone: 609-807-1604
  • Fax:
Mailing address:
  • Phone: 609-807-1604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number338306
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number1477684
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: