Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TH0100X | Health Service |
NPI | 1255952230 |
---|---|
Provider Name | Janelle R Jefferson |
First Address | Easton, PA 18042-4673 |
Second Address | Easton, PA 18042-4673 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2020 |
Last Update Date | 01/05/2020 |