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General NPI Number Information
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NPI Number | 1316339963
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Entity Type | Individual
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Provider Name | EMILY JUBECK MA, LPC
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Gender | Female
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Dates
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Enumeration Date | 02/19/2015
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Last Update Date | 05/06/2019
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Provider Practice Location Address
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Address Line | 2500 GRUBB RD STE 240
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City | WILMINGTON
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State | DE
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Zip | 19810-4796
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Country | US
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Telephone | 302-475-1880
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Fax |
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Provider Business Mailing Address
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Address Line | 217 N ADAMS ST APT A
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City | WEST CHESTER
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State | PA
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Zip | 19380-2701
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Country | US
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Telephone | 484-354-9795
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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 | PC-011074
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License Number State | PA
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