Individual
DR. JESSICA HENNINGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD,
Contact information
Practice address
1235 PINE ST, PHILADELPHIA, PA 19107-5945
(215) 735-9379
Mailing address
255 S 17TH ST, PHILADELPHIA, PA 19103-6231
(267) 209-3209
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
103T00000X
Psychologist
PS019704
PA
Other
Enumeration date
08/15/2014
Last updated
10/13/2022
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