Provider Demographics
NPI:1699576181
Name:WALLING, JENNIFER G (QMHS-A)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:G
Last Name:WALLING
Suffix:
Gender:
Credentials:QMHS-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 947
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-0947
Mailing Address - Country:US
Mailing Address - Phone:740-687-0835
Mailing Address - Fax:740-687-9391
Practice Address - Street 1:2652 KULL RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-7707
Practice Address - Country:US
Practice Address - Phone:740-687-0835
Practice Address - Fax:740-687-9391
Is Sole Proprietor?:No
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator