Provider Demographics
NPI:1821706961
Name:WEGMAN, JENNIFER BROWN (MA, NCC, CCSP, CCC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:BROWN
Last Name:WEGMAN
Suffix:
Gender:F
Credentials:MA, NCC, CCSP, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4 WELLINGTON BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1800
Mailing Address - Country:US
Mailing Address - Phone:610-985-0711
Mailing Address - Fax:610-743-8657
Practice Address - Street 1:4 WELLINGTON BLVD STE 202
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1800
Practice Address - Country:US
Practice Address - Phone:610-985-0711
Practice Address - Fax:610-743-8657
Is Sole Proprietor?:No
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health