Provider Demographics
NPI:1295289627
Name:VONDLE, JENNIFER PASKIEWICZ (MS, LMFT)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:PASKIEWICZ
Last Name:VONDLE
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 ELGIN RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-3717
Mailing Address - Country:US
Mailing Address - Phone:203-823-6313
Mailing Address - Fax:
Practice Address - Street 1:50 BROAD ST
Practice Address - Street 2:UNIT 29
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-4700
Practice Address - Country:US
Practice Address - Phone:203-823-6313
Practice Address - Fax:833-254-1975
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-15
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002027106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist