Provider Demographics
NPI:1063965200
Name:GARVEY, JENNIFER
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:GARVEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2106 LEGACY LN
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17053-9788
Mailing Address - Country:US
Mailing Address - Phone:717-957-2450
Mailing Address - Fax:
Practice Address - Street 1:2106 LEGACY LN
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17053-9788
Practice Address - Country:US
Practice Address - Phone:717-957-2450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-24
Last Update Date:2016-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool