Provider Demographics
NPI:1154531788
Name:JENNINGS, PATRICIA E (LMFT)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:E
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 COUGAR TRAIL
Mailing Address - Street 2:
Mailing Address - City:RIDGWAY
Mailing Address - State:CO
Mailing Address - Zip Code:81432-8926
Mailing Address - Country:US
Mailing Address - Phone:970-626-4086
Mailing Address - Fax:970-626-9700
Practice Address - Street 1:40 COUGAR TRAIL
Practice Address - Street 2:
Practice Address - City:RIDGWAY
Practice Address - State:CO
Practice Address - Zip Code:81432-8926
Practice Address - Country:US
Practice Address - Phone:970-626-4086
Practice Address - Fax:970-626-9700
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO361174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist