Organization
JLG HUDAK LLC
Active
Other names
HeartSpace Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER N HUDAK LPC (FOUNDER/CEO)
(412) 568-3801
Entity
Organization
Contact information
Practice address
720 WOODLAND RD, BRADFORDWOODS, PA 15015-1328
(412) 568-3801
Mailing address
1150 FIRST AVE STE 511, KING OF PRUSSIA, PA 19406-1316
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PC013866
COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF STATE BUREAU OF PROFESSIONAL AND OCCU
PA
01
—
PRC200001358
THE GOVERNMENT OF THE DISTRICT OF COLUMBIA DEPARTMENT OF HEALTH BOARD OF PROFESS
DC
Enumeration date
12/05/2022
Last updated
05/14/2024
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