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General NPI Number Information
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NPI Number | 1871010397
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Entity Type | Individual
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Provider Name | JOCELYN LEA DAIGLE BC-DMT, LPC, LCPC
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Gender | Female
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Dates
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Enumeration Date | 08/25/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2201 CHAPEL AVENUE W
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City | CHERRY HILL
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State | NJ
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Zip | 08002
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Country | US
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Telephone | 856-488-6701
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Fax |
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Provider Business Mailing Address
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Address Line | 2201 CHAPEL AVE W
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City | CHERRY HILL
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State | NJ
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Zip | 08002-2048
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Country | US
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Telephone | 856-488-6701
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | CC4313
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC007516
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 225600000X
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Taxonomy Name | Dance Therapist
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License Number | BC-DMT-1130
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 37PC00578200
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License Number State | NJ
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