Provider Demographics
NPI:1538997234
Name:COONEY, JENNIFER VANHEESWYK (FUNCTIONAL NUTRITION)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:VANHEESWYK
Last Name:COONEY
Suffix:
Gender:F
Credentials:FUNCTIONAL NUTRITION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1721 VALLEY FORGE RD UNIT 425
Mailing Address - Street 2:
Mailing Address - City:VALLEY FORGE
Mailing Address - State:PA
Mailing Address - Zip Code:19481-1620
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1721 VALLEY FORGE RD UNIT 425
Practice Address - Street 2:
Practice Address - City:VALLEY FORGE
Practice Address - State:PA
Practice Address - Zip Code:19481-1620
Practice Address - Country:US
Practice Address - Phone:610-525-6605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-24
Last Update Date:2024-10-06
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach