Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | ||
N | 103TC1900X | Counseling Psychologist | PS-015310 | PA |
N | 103TF0000X | Family Psychologist |
NPI | 1174616239 |
---|---|
Provider Name | Jennifer L. Tzoumas |
First Address | Wyomissing, PA 19610-6977 |
Second Address | Wyomissing, PA 19610-6977 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 24/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P75578 | (02) | PA |