Provider Demographics
NPI:1871004267
Name:JAFFE, ANNA SOPHIA
Entity Type:Individual
Prefix:MISS
First Name:ANNA
Middle Name:SOPHIA
Last Name:JAFFE
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:SOPHIE
Other - Middle Name:
Other - Last Name:JAFFE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1019 W 9TH AVE STE D
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-1220
Mailing Address - Country:US
Mailing Address - Phone:610-992-9900
Mailing Address - Fax:610-992-9999
Practice Address - Street 1:1019 W 9TH AVE STE D
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-1220
Practice Address - Country:US
Practice Address - Phone:610-992-9900
Practice Address - Fax:610-992-9999
Is Sole Proprietor?:No
Enumeration Date:2017-10-12
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician