Provider Demographics
NPI:1407178932
Name:GELFAND, JENNIE WALL (PSYD)
Entity type:Individual
Prefix:
First Name:JENNIE
Middle Name:WALL
Last Name:GELFAND
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:JENNIE
Other - Middle Name:PAINTER
Other - Last Name:WALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:807 S. GEORGE ST.
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403
Mailing Address - Country:US
Mailing Address - Phone:717-843-6561
Mailing Address - Fax:717-845-6941
Practice Address - Street 1:807 S. GEORGE ST.
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403
Practice Address - Country:US
Practice Address - Phone:717-843-6561
Practice Address - Fax:717-845-6941
Is Sole Proprietor?:No
Enumeration Date:2010-02-25
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS016747103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist