Individual
JENNIFER ELIZABETH FUSTINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 DOGWOOD DR, PHILIPSBURG, PA 16866-1982
(814) 342-8400
Mailing address
402 PATTERSON AVE, DU BOIS, PA 15801-1424
(814) 771-4993
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL014522
PA
Other
Enumeration date
10/28/2019
Last updated
10/28/2019
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