Provider Demographics
NPI:1487921797
Name:HOVANCE, JENNIFER LAUREN (PSYD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LAUREN
Last Name:HOVANCE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 WHITE PLAINS RD STE 27
Mailing Address - Street 2:
Mailing Address - City:EASTCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10709-5537
Mailing Address - Country:US
Mailing Address - Phone:732-890-8610
Mailing Address - Fax:
Practice Address - Street 1:475 WHITE PLAINS RD STE 27
Practice Address - Street 2:
Practice Address - City:EASTCHESTER
Practice Address - State:NY
Practice Address - Zip Code:10709-5537
Practice Address - Country:US
Practice Address - Phone:732-890-8610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-30
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019410103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical