Doctor Name: | JEANINE P AVERSA |
NPI Number: | 1235302712 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | PC004812 |
Business Practice Address: | 273 W Uwchlan Ave Downingtown, PA - 193353361 |
Business Phone Number: | 6108734748 |
Business Fax Number: | |
Mailing Address: | 273 W Uwchlan Ave, DOWNINGTOWN |
State: | PA |
Postal Code: | 193353361 |
Phone Number: | 6108734748 |
Fax Number: | |
NPI Enumeration Date: | 04/07/2008 |
NPI Last Update Date: | 04/07/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | PC004812 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |