Provider Demographics
NPI:1912239021
Name:TELFAIR, JENNIFER MEGAN (EDM)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MEGAN
Last Name:TELFAIR
Suffix:
Gender:F
Credentials:EDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1740 POTOMAC AVE SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-3135
Mailing Address - Country:US
Mailing Address - Phone:202-657-9557
Mailing Address - Fax:
Practice Address - Street 1:1740 POTOMAC AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-3135
Practice Address - Country:US
Practice Address - Phone:202-657-9557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-01
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC14075101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor