Provider Demographics
NPI:1083014856
Name:EPSTEIN, JENNA
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:EPSTEIN
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 1:1243 SHED RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15522-8584
Mailing Address - Country:US
Mailing Address - Phone:814-623-5166
Mailing Address - Fax:
Practice Address - Street 1:245 W RACE ST
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:PA
Practice Address - Zip Code:15501-1922
Practice Address - Country:US
Practice Address - Phone:814-443-4891
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-29
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor