Healthcare Provider Details

I. General information

NPI: 1922927466
Provider Name (Legal Business Name): JENNIFER E HEINRICH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 SILVERMINE RD
BROOKFIELD CT
06804-2047
US

IV. Provider business mailing address

6 DRUMCLIFFE DR
WARREN PA
16365-3516
US

V. Phone/Fax

Practice location:
  • Phone: 888-374-0855
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberTEI004321
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: