Individual
MS. JENNY GASTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3905 FORD RD, PHILADELPHIA, PA 19131-2824
(215) 878-3400
(215) 878-2082
Mailing address
5523 DELANCEY ST, PHILADELPHIA, PA 19143-1309
(215) 758-7889
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PC005719
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
23-1728027
—
PA
Enumeration date
10/10/2008
Last updated
06/21/2023
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