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General NPI Number Information
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NPI Number | 1811060148
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Entity Type | Individual
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Provider Name | JEANNE DAWN CANTRELL PH.D.
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Gender | Female
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 02/03/2016
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Provider Practice Location Address
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Address Line | 1000 HERRONTOWN RD
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City | PRINCETON
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State | NJ
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Zip | 08540-7716
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Country | US
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Telephone | 609-560-9116
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Fax | 215-321-4265
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Provider Business Mailing Address
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Address Line | 918 MORGAN DR
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City | YARDLEY
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State | PA
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Zip | 19067-4308
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Country | US
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Telephone | 215-493-1862
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Fax | 215-321-4265
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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 | 35S100293500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS007211L
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License Number State | PA
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