| Doctor Name: | JEANNE S CENTOFANTI |
| NPI Number: | 1164811345 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, LGPC |
| License Number: | LGP5908 |
| Business Practice Address: | 6196 Oxon Hill Rd Suite 340 Oxon Hill, MD - 207453100 |
| Business Phone Number: | 3018391960 |
| Business Fax Number: | 3018391961 |
| Mailing Address: | 6196 Oxon Hill Rd., Suite 340 OXON HILL |
| State: | MD |
| Postal Code: | 20745 |
| Phone Number: | 4107368704 |
| Fax Number: | |
| NPI Enumeration Date: | 01/12/2015 |
| NPI Last Update Date: | 01/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | LGP5908 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |