Individual
JENNIFER R DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1601 SASSAFRAS ST, ERIE, PA 16502-1858
(814) 528-0600
(814) 528-0601
Mailing address
1601 SASSAFRAS ST, ERIE, PA 16502-1858
(814) 528-0815
(814) 528-0601
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102632671
—
PA
Enumeration date
02/19/2020
Last updated
04/28/2021
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