Provider Demographics
NPI:1023579265
Name:PLEASURE, JENNIFER RACHEL (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:RACHEL
Last Name:PLEASURE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1492 UNQUOWA RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-4950
Mailing Address - Country:US
Mailing Address - Phone:202-253-4475
Mailing Address - Fax:
Practice Address - Street 1:1492 UNQUOWA RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-4950
Practice Address - Country:US
Practice Address - Phone:202-253-4475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-29
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003431103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist