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Individual

JENNIFER L O'BRIEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, LAPC, ICAADC

Contact information

Practice address
4001 STONEWOOD DR STE 110, WEXFORD, PA 15090-8398
(724) 747-1690
Mailing address
4001 STONEWOOD DR STE 110, WEXFORD, PA 15090-8398
(724) 747-1690

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YP2500X
Professional Counselor
Primary
APC000159
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1265736235
MEDICAID
PA
05
1265736235
PA
Enumeration date
01/05/2011
Last updated
10/17/2024
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