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General NPI Number Information
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NPI Number | 1881059541
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Entity Type | Individual
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Provider Name | JESSICA HENRY
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Gender | Female
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Dates
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Enumeration Date | 12/23/2015
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Last Update Date | 12/23/2015
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Provider Practice Location Address
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Address Line | 530 MARSHALL AVE
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City | PITTSBURGH
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State | PA
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Zip | 15214-3016
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Country | US
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Telephone | 412-992-5628
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Fax |
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Provider Business Mailing Address
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Address Line | 133 ROSSMOR CT
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City | PITTSBURGH
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State | PA
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Zip | 15229-3107
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Country | US
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Telephone | 724-312-4155
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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 | PC008579
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License Number State | PA
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