Healthcare Provider Details

I. General information

NPI: 1902604366
Provider Name (Legal Business Name): JENNIFER ROBIN YOSPA LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2025
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 E PARK ST
ELIZABETHTOWN PA
17022-2267
US

IV. Provider business mailing address

420 E PARK ST
ELIZABETHTOWN PA
17022-2267
US

V. Phone/Fax

Practice location:
  • Phone: 717-282-2908
  • Fax:
Mailing address:
  • Phone: 717-282-2908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW139793
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: