Provider Demographics
NPI:1831667096
Name:KREPPEL, JESSICA (MS, LBS)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:KREPPEL
Suffix:
Gender:F
Credentials:MS, LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:BELMONT HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19004-1920
Mailing Address - Country:US
Mailing Address - Phone:610-742-0893
Mailing Address - Fax:
Practice Address - Street 1:85 OLD EAGLE SCHOOL RD
Practice Address - Street 2:
Practice Address - City:STRAFFORD
Practice Address - State:PA
Practice Address - Zip Code:19087-2556
Practice Address - Country:US
Practice Address - Phone:215-208-9912
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-06
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH003923103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst