Individual
DR. JENA ELISE IANNUZZELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
331 W STATE ST, MEDIA, PA 19063-2615
(610) 565-0515
(610) 566-4141
Mailing address
331 W STATE ST, MEDIA, PA 19063-2615
(610) 565-0515
(610) 566-4141
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
B1-0000783
DE
103TC0700X
Clinical Psychologist
Primary
PS016444
PA
Other
Enumeration date
02/17/2010
Last updated
02/17/2010
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