Provider Demographics
NPI:1568659613
Name:HARPER, JENNIFER RUEB (MDIV, LP)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:RUEB
Last Name:HARPER
Suffix:
Gender:F
Credentials:MDIV, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 E 25TH ST
Mailing Address - Street 2:SUITE 7B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-2945
Mailing Address - Country:US
Mailing Address - Phone:212-242-3585
Mailing Address - Fax:
Practice Address - Street 1:51 E 25TH ST
Practice Address - Street 2:SUITE 7B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-2945
Practice Address - Country:US
Practice Address - Phone:212-242-3585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-02
Last Update Date:2012-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY19-000790102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst