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General NPI Number Information
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NPI Number | 1801013206
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Entity Type | Individual
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Provider Name | JENNIFER JACKSON HOLDEN PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 41 LEOPARD RD STE 304 CENTER FOR PSYCHOLOGICAL SERVICES
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City | PAOLI
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State | PA
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Zip | 19301-1549
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Country | US
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Telephone | 610-647-6406
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Fax |
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Provider Business Mailing Address
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Address Line | 125 COULTER AVE CENTER FOR PSYCHOLOGICAL SERVICES
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City | ARDMORE
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State | PA
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Zip | 19003-2410
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Country | US
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Telephone | 610-642-4873
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS008633L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State |
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