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General NPI Number Information
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NPI Number | 1396213641
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Entity Type | Individual
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Provider Name | DAENA LYNN LONGENECKER LMFT
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Gender | Female
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Dates
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Enumeration Date | 11/05/2018
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Last Update Date | 11/05/2018
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Provider Practice Location Address
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Address Line | 83 E MAIN ST
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City | MOUNT JOY
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State | PA
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Zip | 17552-1424
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Country | US
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Telephone | 717-413-9594
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Fax |
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Provider Business Mailing Address
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Address Line | 83 EAST MAIN STREET PO BOX 357
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City | MT. JOY
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State | PA
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Zip | 17552
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Country | US
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Telephone | 717-413-9594
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MF000895
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License Number State | PA
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