Provider Demographics
NPI:1316448780
Name:ANDERSON, JENNIFER RENEE (NCC)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:RENEE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 MCKEAN AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLEROI
Mailing Address - State:PA
Mailing Address - Zip Code:15022-1436
Mailing Address - Country:US
Mailing Address - Phone:412-246-8965
Mailing Address - Fax:
Practice Address - Street 1:17 MCKEAN AVE
Practice Address - Street 2:
Practice Address - City:CHARLEROI
Practice Address - State:PA
Practice Address - Zip Code:15022-1436
Practice Address - Country:US
Practice Address - Phone:412-246-8965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-21
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor