Individual
JEFFREY COLLEGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
618 CUMBERLAND ST, LEBANON, PA 17042-5232
(717) 274-2741
Mailing address
200 N 7TH ST, LEBANON, PA 17046-5040
(717) 272-5464
(717) 273-1416
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
Primary
PC010482
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1035123910001
—
PA
Enumeration date
11/25/2015
Last updated
08/07/2019
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