Individual
DR. JEANNINE CICCO BARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
255 S 17TH ST STE 2121, PHILADELPHIA, PA 19103-6211
(215) 839-9179
Mailing address
PO BOX 2401, PHILADELPHIA, PA 19147-0401
(215) 839-9179
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS018131
PA
Other
Enumeration date
12/19/2019
Last updated
10/17/2022
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