| Doctor Name: | DR. JEBEDIAH JAMES NORTHERN |
| NPI Number: | 1932470309 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | PS017155 |
| Business Practice Address: | 1010 Delafield Rd Vaphs - Heinz Division 130p-a Aspinwall, PA - 152151802 |
| Business Phone Number: | 4128222387 |
| Business Fax Number: | |
| Mailing Address: | 1010 Delafield Rd, Vaphs - Heinz Division 130p-a ASPINWALL |
| State: | PA |
| Postal Code: | 152151802 |
| Phone Number: | 4128222387 |
| Fax Number: | |
| NPI Enumeration Date: | 01/18/2012 |
| NPI Last Update Date: | 01/18/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PS017155 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |