Provider Demographics
NPI:1396190351
Name:FRIEDLUND, JENNA
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:FRIEDLUND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:975 CLARK ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-3201
Mailing Address - Country:US
Mailing Address - Phone:484-332-3647
Mailing Address - Fax:
Practice Address - Street 1:283 BUTLER RD
Practice Address - Street 2:
Practice Address - City:MOUNT GRETNA
Practice Address - State:PA
Practice Address - Zip Code:17064-6085
Practice Address - Country:US
Practice Address - Phone:717-368-8076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-27
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW132242104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker