Provider Demographics
NPI:1790677367
Name:GUGLIELMO, JENNIFER (MFT-A)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:GUGLIELMO
Suffix:
Gender:F
Credentials:MFT-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:775 E HOLLAND AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-5016
Mailing Address - Country:US
Mailing Address - Phone:509-223-2032
Mailing Address - Fax:
Practice Address - Street 1:775 E HOLLAND AVE STE 102
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-5016
Practice Address - Country:US
Practice Address - Phone:509-223-2032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist