Provider Demographics
NPI:1649601360
Name:DILOSSI, JENNA (MS, NCC, LPC)
Entity Type:Individual
Prefix:MS
First Name:JENNA
Middle Name:
Last Name:DILOSSI
Suffix:
Gender:F
Credentials:MS, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 FOMALHAUT AVE
Mailing Address - Street 2:
Mailing Address - City:TURNERSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-2416
Mailing Address - Country:US
Mailing Address - Phone:856-981-8545
Mailing Address - Fax:610-527-9361
Practice Address - Street 1:20 FOMALHAUT AVE
Practice Address - Street 2:
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012-2416
Practice Address - Country:US
Practice Address - Phone:856-981-8545
Practice Address - Fax:610-527-9361
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-05
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007233101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health