Provider Demographics
NPI:1720262140
Name:JASINSKI, JOAN
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:JASINSKI
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 1:201 JEFFERSON CT
Mailing Address - Street 2:
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-1418
Mailing Address - Country:US
Mailing Address - Phone:610-363-1488
Mailing Address - Fax:610-636-8273
Practice Address - Street 1:1405 N CEDAR CREST BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-2308
Practice Address - Country:US
Practice Address - Phone:610-435-4151
Practice Address - Fax:610-435-3044
Is Sole Proprietor?:No
Enumeration Date:2007-12-20
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW012620E1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool