Provider Demographics
NPI:1992867741
Name:ORLEANS, JENNIFER (PHD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:ORLEANS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 N CAYUGA ST
Mailing Address - Street 2:SUITE 209 DEWITT BLDG, BOX 36
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-4329
Mailing Address - Country:US
Mailing Address - Phone:607-273-5522
Mailing Address - Fax:707-281-7600
Practice Address - Street 1:215 N CAYUGA ST
Practice Address - Street 2:SUITE 209 DEWITT BLDG, BOX 36
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-4329
Practice Address - Country:US
Practice Address - Phone:607-273-5522
Practice Address - Fax:707-281-7600
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011587103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical