Provider Demographics
NPI:1982893178
Name:ENGLE, JESSICA L (PHD)
Entity Type:Individual
Prefix:MISS
First Name:JESSICA
Middle Name:L
Last Name:ENGLE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:L
Other - Last Name:ENGLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1930 MONROE ST.
Mailing Address - Street 2:SUITE 359
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711
Mailing Address - Country:US
Mailing Address - Phone:541-941-6044
Mailing Address - Fax:
Practice Address - Street 1:1930 MONROE STREET
Practice Address - Street 2:SUITE 359
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711
Practice Address - Country:US
Practice Address - Phone:415-681-3211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-23
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor