Provider Demographics
NPI:1326003054
Name:JENNINGS, DONALD E (EDD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:E
Last Name:JENNINGS
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:826 BUSTLETON PIKE
Mailing Address - Street 2:STE 109
Mailing Address - City:FEASTERVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19053
Mailing Address - Country:US
Mailing Address - Phone:215-364-5780
Mailing Address - Fax:215-364-5782
Practice Address - Street 1:826 BUSTLETON PIKE
Practice Address - Street 2:STE 109
Practice Address - City:FEASTERVILLE
Practice Address - State:PA
Practice Address - Zip Code:19053
Practice Address - Country:US
Practice Address - Phone:215-364-5780
Practice Address - Fax:215-364-5782
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAP001100L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1664257OtherBLUE CHOICE PERSONAL CHOI
6162934OtherUBH
45600700OtherMAGELLAN
1664257OtherBLUE CHOICE PERSONAL CHOI