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General NPI Number Information
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NPI Number | 1679238703
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Entity Type | Individual
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Provider Name | JODI KRISTINA CAPMAN
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Gender | Female
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Dates
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Enumeration Date | 11/03/2021
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Last Update Date | 11/03/2021
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Provider Practice Location Address
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Address Line | 180 TICES LN STE 202
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-1345
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Country | US
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Telephone | 732-354-0050
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Fax | 732-325-0334
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Provider Business Mailing Address
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Address Line | 1 TRACEY DR
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City | MILLTOWN
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State | NJ
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Zip | 08850-1917
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Country | US
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Telephone | 732-718-7787
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 37AC00524500
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License Number State | NJ
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