Basic Information
| Provider Information | |||||||||
| NPI: | 1851721104 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MERCADANTE | ||||||||
| FirstName: | JENNA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PSYD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1754 RUSSELL RD | ||||||||
| Address2: | APT B | ||||||||
| City: | PAOLI | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193011224 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7247774820 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1400 BLACKHORSE HILL RD | ||||||||
| Address2: | |||||||||
| City: | COATESVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193202040 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6103847711 | ||||||||
| FaxNumber: | 6103804318 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/24/2013 | ||||||||
| LastUpdateDate: | 11/24/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | PS017488 | PA | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.