Provider Demographics
NPI:1699361733
Name:O'HARE, JENNIFER ROSE
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ROSE
Last Name:O'HARE
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 1:689 N HERMITAGE RD STE 4
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-3237
Mailing Address - Country:US
Mailing Address - Phone:724-983-1940
Mailing Address - Fax:724-983-1963
Practice Address - Street 1:689 N HERMITAGE RD STE 4
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-3237
Practice Address - Country:US
Practice Address - Phone:724-983-1940
Practice Address - Fax:724-983-1963
Is Sole Proprietor?:No
Enumeration Date:2020-12-14
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health