Provider Demographics
NPI:1912964099
Name:DENNEHY-JENNINGS, JENNIFER LYNN (MS, PT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:DENNEHY-JENNINGS
Suffix:
Gender:F
Credentials:MS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5069 SPANISH OAKS CT
Mailing Address - Street 2:
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576-5448
Mailing Address - Country:US
Mailing Address - Phone:843-357-6935
Mailing Address - Fax:843-357-6935
Practice Address - Street 1:5069 SPANISH OAKS CT
Practice Address - Street 2:
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576-5448
Practice Address - Country:US
Practice Address - Phone:843-357-6935
Practice Address - Fax:843-357-6935
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC34952251P0200X
MA107302251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCTHO829Medicaid