Provider Demographics
NPI:1467990606
Name:COTTON, JENNA
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:COTTON
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 1:770 MARNE HWY STE 2D
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-3081
Mailing Address - Country:US
Mailing Address - Phone:609-201-1001
Mailing Address - Fax:
Practice Address - Street 1:770 MARNE HWY STE 2D
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-3081
Practice Address - Country:US
Practice Address - Phone:609-201-1001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-08
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0193621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical