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General NPI Number Information
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NPI Number | 1578928727
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Entity Type | Individual
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Provider Name | JENNIFER LORRAINE BROSENITSCH LPC
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Gender | Female
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Dates
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Enumeration Date | 12/15/2015
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Last Update Date | 07/02/2018
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Provider Practice Location Address
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Address Line | 101 OAK RIDGE DR STE E
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City | BUTLER
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State | PA
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Zip | 16002
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Country | US
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Telephone | 724-453-4595
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Fax |
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Provider Business Mailing Address
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Address Line | 350 N MAIN ST
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City | BUTLER
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State | PA
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Zip | 16001-4921
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Country | US
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Telephone | 724-287-5604
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Fax | 724-287-3779
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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 | PC008606
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License Number State | PA
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