Individual
JENNIFER C NISSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6 NORTH WILLOW ST, FREEBURG, PA 17827-0000
(717) 991-5604
Mailing address
335 S FRANKLIN ST, WILKES BARRE, PA 18702-3808
(570) 825-6425
(570) 762-9013
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007777400036
—
PA
Enumeration date
09/09/2009
Last updated
12/22/2022
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