Provider Demographics
NPI:1467835298
Name:PINAMONTI, JOLYN A
Entity Type:Individual
Prefix:
First Name:JOLYN
Middle Name:A
Last Name:PINAMONTI
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 1:325 SW FRAZIER AVE
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-1963
Mailing Address - Country:US
Mailing Address - Phone:785-232-5005
Mailing Address - Fax:
Practice Address - Street 1:910 S CHAPEL ST STE 102
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-3468
Practice Address - Country:US
Practice Address - Phone:302-224-1400
Practice Address - Fax:302-525-6706
Is Sole Proprietor?:No
Enumeration Date:2015-06-29
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2612103T00000X
DEB10001150103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist