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General NPI Number Information
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NPI Number | 1851242432
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Entity Type | Individual
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Provider Name | JENNA LYNN DAMICO PH.D.
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Gender | Female
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Dates
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Enumeration Date | 02/09/2026
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Last Update Date | 02/09/2026
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Provider Practice Location Address
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Address Line | 601 EWING ST STE C2
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City | PRINCETON
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State | NJ
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Zip | 08540-2756
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Country | US
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Telephone | 856-220-9672
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Fax | 856-673-0630
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Provider Business Mailing Address
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Address Line | 1101 E HECTOR ST UNIT 362
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City | CONSHOHOCKEN
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State | PA
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Zip | 19428-2451
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Country | US
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Telephone | 248-462-3224
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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 | PS020687
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License Number State | PA
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