Healthcare Provider Details

I. General information

NPI: 1376023606
Provider Name (Legal Business Name): JENNIFER HUBER LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2018
Last Update Date: 08/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

519 PENN AVE STE 202
TURTLE CREEK PA
15145-2082
US

IV. Provider business mailing address

519 PENN AVE STE 202
TURTLE CREEK PA
15145-2082
US

V. Phone/Fax

Practice location:
  • Phone: 412-824-0948
  • Fax:
Mailing address:
  • Phone: 412-824-0948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW135154
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierNONE
Identifier TypeOTHER
Identifier State
Identifier IssuerNONE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: