Healthcare Provider Details

I. General information

NPI: 1952227720
Provider Name (Legal Business Name): JENNIFER MARIE YOUNKIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1008 THOMPSON ST
JERSEY SHORE PA
17740-1729
US

IV. Provider business mailing address

309 MAPLE ST
JERSEY SHORE PA
17740-1619
US

V. Phone/Fax

Practice location:
  • Phone: 570-398-4747
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOP009826
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: