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General NPI Number Information
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NPI Number | 1164795050
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Entity Type | Individual
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Provider Name | JESSICA SANTELLA B.A.
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Gender | Female
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Dates
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Enumeration Date | 02/22/2012
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Last Update Date | 02/22/2012
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Provider Practice Location Address
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Address Line | 583 SHOEMAKER RD SUITE 230
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City | KING OF PRUSSIA
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State | PA
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Zip | 19406-4201
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Country | US
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Telephone | 484-324-8307
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Fax | 484-320-8307
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Provider Business Mailing Address
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Address Line | 583 SHOEMAKER RD SUITE 230
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City | KING OF PRUSSIA
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State | PA
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Zip | 19406-4201
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Country | US
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Telephone | 484-324-8307
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Fax | 484-320-8307
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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