Provider Demographics
NPI:1982312575
Name:JENNE, ROBERT ALLAN (BSL)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:ALLAN
Last Name:JENNE
Suffix:
Gender:M
Credentials:BSL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-1959
Mailing Address - Country:US
Mailing Address - Phone:267-421-2324
Mailing Address - Fax:
Practice Address - Street 1:420 COWPATH RD
Practice Address - Street 2:
Practice Address - City:SOUDERTON
Practice Address - State:PA
Practice Address - Zip Code:18964-2036
Practice Address - Country:US
Practice Address - Phone:267-203-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-11
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor