Provider Demographics
NPI:1427621176
Name:PARRETT, JENNIFER LYNNE (CDCA)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNNE
Last Name:PARRETT
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 S SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:45177-2791
Mailing Address - Country:US
Mailing Address - Phone:937-414-2016
Mailing Address - Fax:937-366-6814
Practice Address - Street 1:602 S SOUTH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:OH
Practice Address - Zip Code:45177-2791
Practice Address - Country:US
Practice Address - Phone:937-414-2016
Practice Address - Fax:937-366-6814
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-21
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH177507101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor