Individual
AUDREY JEAN-JACQUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
3850 WOODHAVEN RD # HOUSE804, PHILADELPHIA, PA 19154-2730
(267) 760-3759
Mailing address
3850 WOODHAVEN RD # HOUSE804, PHILADELPHIA, PA 19154-2730
(267) 760-3759
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PC011560
PA
Other
Enumeration date
07/11/2019
Last updated
04/15/2021
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