Provider Demographics
NPI:1477780690
Name:BROWNE, JESSICA J
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:J
Last Name:BROWNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:J
Other - Last Name:CREPEAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSS & MLSP
Mailing Address - Street 1:6122 RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-1603
Mailing Address - Country:US
Mailing Address - Phone:215-487-1330
Mailing Address - Fax:
Practice Address - Street 1:6122 RIDGE AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128-1603
Practice Address - Country:US
Practice Address - Phone:215-487-1330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-15
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPHCPE47108OtherPHILADELPHIA INDEMNITY INSURANCE COMPANY