Provider Demographics
NPI:1306597372
Name:LIMM, JENNY (MFT, MED)
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:
Last Name:LIMM
Suffix:
Gender:F
Credentials:MFT, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 BYBERRY RD
Mailing Address - Street 2:
Mailing Address - City:HATBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19040-3205
Mailing Address - Country:US
Mailing Address - Phone:267-570-7020
Mailing Address - Fax:
Practice Address - Street 1:67 BYBERRY RD
Practice Address - Street 2:
Practice Address - City:HATBORO
Practice Address - State:PA
Practice Address - Zip Code:19040-3205
Practice Address - Country:US
Practice Address - Phone:267-570-7020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-12
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
00000000OtherNOT AVAILABLE