Basic Information
| Provider Information | |||||||||
| NPI: | 1336671973 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BECHTLER | ||||||||
| FirstName: | JACLYN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2029 CEDAR LN | ||||||||
| Address2: | |||||||||
| City: | OCEAN VIEW | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 082301141 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6096758340 | ||||||||
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| Practice Location | |||||||||
| Address1: | 42 DELSEA DR S | ||||||||
| Address2: | |||||||||
| City: | GLASSBORO | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080282621 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8568818689 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/02/2017 | ||||||||
| LastUpdateDate: | 04/02/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 37AC00273500 | NJ | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.