Provider Demographics
NPI:1356576904
Name:CUNLIFFE, JACQUELYNN (MSN, PHD)
Entity type:Individual
Prefix:DR
First Name:JACQUELYNN
Middle Name:
Last Name:CUNLIFFE
Suffix:
Gender:F
Credentials:MSN, PHD
Other - Prefix:DR
Other - First Name:JACQUELYNN
Other - Middle Name:CUNLIFFE
Other - Last Name:EMINI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, PHD
Mailing Address - Street 1:341 HOMESTEAD RD
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-2431
Mailing Address - Country:US
Mailing Address - Phone:610-341-9409
Mailing Address - Fax:
Practice Address - Street 1:341 HOMESTEAD RD
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-2431
Practice Address - Country:US
Practice Address - Phone:610-341-9409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-27
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN262975L101YM0800X
PAUP001449G101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health