Provider Demographics
NPI:1497151963
Name:GOLDHAMMER, JENNIFER (MA, MT-BC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:GOLDHAMMER
Suffix:
Gender:F
Credentials:MA, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4406 LOCUST ST
Mailing Address - Street 2:APT 2R
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-2923
Mailing Address - Country:US
Mailing Address - Phone:301-467-3525
Mailing Address - Fax:
Practice Address - Street 1:4406 LOCUST ST
Practice Address - Street 2:APT 2R
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-2923
Practice Address - Country:US
Practice Address - Phone:301-467-3525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-11
Last Update Date:2014-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA10999225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist