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General NPI Number Information
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NPI Number | 1194954511
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Entity Type | Individual
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Provider Name | JENNIFER PULLARO LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/07/2009
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Last Update Date | 08/02/2024
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Provider Practice Location Address
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Address Line | 536 MAPLE AVE
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City | LINWOOD
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State | NJ
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Zip | 08221-1213
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Country | US
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Telephone | 609-703-7849
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Fax |
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Provider Business Mailing Address
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Address Line | 8 LEEDS POINT RD
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City | GALLOWAY
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State | NJ
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Zip | 08205-4203
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Country | US
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Telephone | 609-412-4440
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 44SC05397200
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License Number State | NJ
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