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General NPI Number Information
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NPI Number | 1447072558
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Entity Type | Individual
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Provider Name | JESSICA JEAN REDMOND DMFT LPC
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Gender | Female
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Dates
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Enumeration Date | 10/29/2024
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 301 RUTHAR DR STE C
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City | NEWARK
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State | DE
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Zip | 19711-8031
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Country | US
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Telephone | 484-899-0311
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Fax |
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Provider Business Mailing Address
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Address Line | 176 TULSK RD
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City | AVONDALE
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State | PA
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Zip | 19311-1381
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Country | US
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Telephone | 267-530-1947
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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-0011699
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC016670
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License Number State | PA
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