Provider Demographics
NPI:1518737220
Name:LIGHT, JENNA NICOLE (MS)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:NICOLE
Last Name:LIGHT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 BINGHAM ST FL 1
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15203-1009
Mailing Address - Country:US
Mailing Address - Phone:412-380-0100
Mailing Address - Fax:
Practice Address - Street 1:809 BINGHAM ST FL 1
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15203-1009
Practice Address - Country:US
Practice Address - Phone:412-380-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor