Provider Demographics
NPI:1669297974
Name:FEATHER, JAZELLE ZEINA-MARIE
Entity type:Individual
Prefix:
First Name:JAZELLE
Middle Name:ZEINA-MARIE
Last Name:FEATHER
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 1:415 LAURELWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DOUGLASSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19518-1011
Mailing Address - Country:US
Mailing Address - Phone:248-895-4500
Mailing Address - Fax:
Practice Address - Street 1:1800 E HIGH ST
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-3239
Practice Address - Country:US
Practice Address - Phone:484-280-0639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC012344101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional