Provider Demographics
NPI:1477850634
Name:JENNY, MADELEINE BABETTE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MADELEINE
Middle Name:BABETTE
Last Name:JENNY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 586
Mailing Address - Street 2:
Mailing Address - City:UNIONVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19375-0586
Mailing Address - Country:US
Mailing Address - Phone:610-999-3303
Mailing Address - Fax:610-486-6859
Practice Address - Street 1:650 BRANDYWINE CREEK ROAD
Practice Address - Street 2:NEWLIN TOWNSHIP
Practice Address - City:COATESVILLE
Practice Address - State:PA
Practice Address - Zip Code:19320
Practice Address - Country:US
Practice Address - Phone:610-999-3303
Practice Address - Fax:610-486-6859
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-23
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005643-L103T00000X
PAPS-005643-L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical