Provider Demographics
NPI:1790556132
Name:TOSLU, JENNIFER (LSW, BCBA)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:TOSLU
Suffix:
Gender:F
Credentials:LSW, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 W WYNCLIFFE AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON HEIGHTS
Mailing Address - State:PA
Mailing Address - Zip Code:19018-1229
Mailing Address - Country:US
Mailing Address - Phone:610-283-2245
Mailing Address - Fax:
Practice Address - Street 1:110 CHURCH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19106-2201
Practice Address - Country:US
Practice Address - Phone:267-807-0550
Practice Address - Fax:704-809-3193
Is Sole Proprietor?:No
Enumeration Date:2024-01-15
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW132311104100000X
PA1-24-77711103K00000X
PABH005917103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No104100000XBehavioral Health & Social Service ProvidersSocial Worker