Doctor Name: | MRS. JENNIFER LEAH GREENBAUM |
NPI Number: | 1598154866 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | PC007814 |
Business Practice Address: | 237 W Lancaster Ave Suite 115 Devon, PA - 193331592 |
Business Phone Number: | 6106878200 |
Business Fax Number: | |
Mailing Address: | 4842 Smick St, PHILADELPHIA |
State: | PA |
Postal Code: | 191271911 |
Phone Number: | 8563137895 |
Fax Number: | |
NPI Enumeration Date: | 01/09/2015 |
NPI Last Update Date: | 01/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | PC007814 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |