Provider Demographics
NPI:1063178523
Name:MAJOR, JENNIFER LOIS LYNADA (PHD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LOIS LYNADA
Last Name:MAJOR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8605 TEMPLE RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19150-1910
Mailing Address - Country:US
Mailing Address - Phone:215-869-3715
Mailing Address - Fax:
Practice Address - Street 1:1500 WALNUT ST STE 1340
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-3513
Practice Address - Country:US
Practice Address - Phone:267-627-1060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling