Provider Demographics
NPI:1356559488
Name:GLASSBRENNER, JENNIFER G (PHD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:G
Last Name:GLASSBRENNER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 HIDDEN TIMBER DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15241-3310
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2550 BOYCE PLAZA RD
Practice Address - Street 2:130
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-3954
Practice Address - Country:US
Practice Address - Phone:412-257-0677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003188101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional