Provider Demographics
NPI:1528219953
Name:FUINI, JILL LAUREN (PH D)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:LAUREN
Last Name:FUINI
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 S COMMERCE WAY STE 100
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-8966
Mailing Address - Country:US
Mailing Address - Phone:610-866-2020
Mailing Address - Fax:610-264-7290
Practice Address - Street 1:54 S COMMERCE WAY STE 100
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-8966
Practice Address - Country:US
Practice Address - Phone:610-866-2020
Practice Address - Fax:610-866-2055
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-03
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-016495103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling