Provider Demographics
NPI:1508290172
Name:DADDARIO, JENNIFER RUTH (M ED)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:RUTH
Last Name:DADDARIO
Suffix:
Gender:F
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 ROTHERMEL DR
Mailing Address - Street 2:
Mailing Address - City:YEAGERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17099-9707
Mailing Address - Country:US
Mailing Address - Phone:717-242-2283
Mailing Address - Fax:
Practice Address - Street 1:25 ROTHERMEL DR
Practice Address - Street 2:
Practice Address - City:YEAGERTOWN
Practice Address - State:PA
Practice Address - Zip Code:17099-9707
Practice Address - Country:US
Practice Address - Phone:717-242-2283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-30
Last Update Date:2013-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health