Provider Demographics
NPI:1063735827
Name:JENNINGS, DANIELLE JORDAN
Entity type:Individual
Prefix:PROF
First Name:DANIELLE
Middle Name:JORDAN
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2917 HUNTINGTON DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-0509
Mailing Address - Country:US
Mailing Address - Phone:850-531-9918
Mailing Address - Fax:
Practice Address - Street 1:2917 HUNTINGTON DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-0509
Practice Address - Country:US
Practice Address - Phone:850-531-9918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker