Derisse, Jennifer D

Derisse, Jennifer D is an individual health care provider with primary practice located at 206 Bergen Ave , Kearny NJ 07032-3384. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Derisse, Jennifer D can be contacted via phone (732) 210-0509.

Contact Information

Primary practice address
206 Bergen Ave Kearny NJ 07032-3384
Phone: (732) 210-0509
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 37LC00296100

Profile Details

NPI number 1336784826
LBN Legal business name Derisse, Jennifer D
Credentials LCADC
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 8th, 2019
Last updated Nov 8th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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