| Jaxie Gunner, Inc. | |
|
408 8th St Suite 5 New Kensington PA 15068-6426 | |
| (724) 980-1504 | |
| (724) 212-3345 |
| Full Name | Jaxie Gunner, Inc. |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 408 8th St, New Kensington, Pennsylvania |
| Authorized Official Name and Position | Jaxie Kay Gunner (PRESIDENT/CEO) |
| Authorized Official Contact | 7249801504 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jaxie Gunner, Inc. 408 8th St Suite 5 New Kensington PA 15068-6426 Ph: () - | Jaxie Gunner, Inc. 408 8th St Suite 5 New Kensington PA 15068-6426 Ph: (724) 980-1504 |
| NPI Number | 1316223076 |
|---|---|
| Provider Enumeration Date | 10/26/2011 |
| Last Update Date | 10/26/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316223076 | NPI | - | NPPES |
| 102458480-0001 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | CW016514 (Pennsylvania) | Primary |
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