Provider Demographics
NPI:1003277989
Name:GE, JENNIFER Y
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:Y
Last Name:GE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:NG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5446 CHIEFTAIN CIR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22312-2344
Mailing Address - Country:US
Mailing Address - Phone:240-393-8899
Mailing Address - Fax:
Practice Address - Street 1:5446 CHIEFTAIN CIR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22312-2344
Practice Address - Country:US
Practice Address - Phone:240-393-8899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-18
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD179871041C0700X
VA09040090231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical