Provider Demographics
NPI:1316913536
Name:AXILBUND, JENNIFER ELIZABETH (MS, CGC)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ELIZABETH
Last Name:AXILBUND
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:ELIZABETH
Other - Last Name:SOLLENBERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CGC
Mailing Address - Street 1:550 N BROADWAY
Mailing Address - Street 2:SUITE 410
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21205-2020
Mailing Address - Country:US
Mailing Address - Phone:410-614-0378
Mailing Address - Fax:410-955-4040
Practice Address - Street 1:550 N BROADWAY
Practice Address - Street 2:SUITE 410
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21205-2020
Practice Address - Country:US
Practice Address - Phone:410-614-0378
Practice Address - Fax:410-955-4040
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2002312170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS