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NPI Code Detail

MEDICARE: JADA LEE PANNELL

MEDICARE: JADA LEE PANNELL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorPA

General Provider Information

NPI Number : 1891319356
Entity Type Code : Individual
Provider Name (Legal Business Name) : JADA LEE PANNELL
Provider Business Mailing Address
First Line : 6425 LIVING PL
Second Line :
City : PITTSBURGH
State : PA
Zip : 15206-5122
Country : US
Telephone Number : 412-694-6627
Fax Number :
Provider Business Practice Location Address
First Line : 6425 LIVING PL
Second Line :
City : PITTSBURGH
State : PA
Zip : 15206-5122
Country : US
Telephone Number : 412-694-6627
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2020
Last Update Date : 06/01/2020

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Directions to “ JADA LEE PANNELL ” Practice Location

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