Provider Demographics
NPI:1649531773
Name:ROSS, JESSICA JOY POEHLER (MA, LMFT)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:JOY POEHLER
Last Name:ROSS
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:310 CENTRAL CITY PLZ
Mailing Address - Street 2:
Mailing Address - City:NEW KENSINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15068-6441
Mailing Address - Country:US
Mailing Address - Phone:724-335-9883
Mailing Address - Fax:724-335-2730
Practice Address - Street 1:310 CENTRAL CITY PLZ
Practice Address - Street 2:
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068-6441
Practice Address - Country:US
Practice Address - Phone:724-335-9883
Practice Address - Fax:724-335-2730
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-05
Last Update Date:2012-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000663106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist