Provider Demographics
NPI:1184355737
Name:MCCAFFERTY, JENNIFER ASHLEY
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ASHLEY
Last Name:MCCAFFERTY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28698 ELDER DR
Mailing Address - Street 2:
Mailing Address - City:NORTH OLMSTED
Mailing Address - State:OH
Mailing Address - Zip Code:44070-5130
Mailing Address - Country:US
Mailing Address - Phone:740-579-1363
Mailing Address - Fax:
Practice Address - Street 1:398 W BAGLEY RD STE 216
Practice Address - Street 2:
Practice Address - City:BEREA
Practice Address - State:OH
Practice Address - Zip Code:44017-1312
Practice Address - Country:US
Practice Address - Phone:216-340-0011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator