Provider Demographics
NPI:1982925525
Name:MCMAHAN, JESSICA L (MS)
Entity Type:Individual
Prefix:MISS
First Name:JESSICA
Middle Name:L
Last Name:MCMAHAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:959 PENN CIR
Mailing Address - Street 2:APT C508
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-1006
Mailing Address - Country:US
Mailing Address - Phone:267-335-7354
Mailing Address - Fax:
Practice Address - Street 1:959 PENN CIR
Practice Address - Street 2:APT C508
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-1006
Practice Address - Country:US
Practice Address - Phone:267-335-7354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor