Individual
KATHLEEN M JANSEN
Active
Individual
KATHLEEN M JANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PS015819
PA
103TC0700X
Clinical Psychologist
Primary
PS015819
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
367035
MHN TRICARE
PA
01
—
815894000
MAGELLAN BEHAVIORAL HEALTH
PA
Enumeration date
07/12/2006
Last updated
09/02/2021
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