Provider Demographics
NPI:1053460048
Name:WURMSER, JEANNE H (PHD)
Entity Type:Individual
Prefix:DR
First Name:JEANNE
Middle Name:H
Last Name:WURMSER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 MISSION HILLS CT
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-2553
Mailing Address - Country:US
Mailing Address - Phone:732-706-7241
Mailing Address - Fax:419-818-2856
Practice Address - Street 1:73 MISSION HILLS CT
Practice Address - Street 2:
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-2553
Practice Address - Country:US
Practice Address - Phone:732-706-7241
Practice Address - Fax:419-818-2856
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00107800103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical