Healthcare Provider Details

I. General information

NPI: 1487921797
Provider Name (Legal Business Name): JENNIFER LAUREN HOVANCE PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2011
Last Update Date: 12/30/2022
Certification Date: 12/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 WHITE PLAINS RD STE 27
EASTCHESTER NY
10709-5537
US

IV. Provider business mailing address

475 WHITE PLAINS RD STE 27
EASTCHESTER NY
10709-5537
US

V. Phone/Fax

Practice location:
  • Phone: 732-890-8610
  • Fax:
Mailing address:
  • Phone: 732-890-8610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number019410
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: