Provider Demographics
NPI:1457447427
Name:JUMPER, ALBERT D (MA)
Entity Type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:D
Last Name:JUMPER
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 CARVERTON RD
Mailing Address - Street 2:
Mailing Address - City:TRUCKSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18708-1719
Mailing Address - Country:US
Mailing Address - Phone:570-696-4783
Mailing Address - Fax:
Practice Address - Street 1:23 W WALNUT ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:PA
Practice Address - Zip Code:18704-3800
Practice Address - Country:US
Practice Address - Phone:570-283-1455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS004206L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist