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General NPI Number Information
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NPI Number | 1295337269
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Entity Type | Individual
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Provider Name | JENNIFER SARAH BREY
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Gender | Female
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Dates
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Enumeration Date | 11/13/2020
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Last Update Date | 11/13/2020
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Provider Practice Location Address
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Address Line | 1221 LOCUST ST STE 205
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City | PHILADELPHIA
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State | PA
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Zip | 19107-5570
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Country | US
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Telephone | 215-681-3692
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Fax |
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Provider Business Mailing Address
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Address Line | 1840 CHRISTIAN ST # 3
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City | PHILADELPHIA
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State | PA
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Zip | 19146-2647
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Country | US
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Telephone | 215-253-9192
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC008345
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License Number State | PA
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