Doctor Name: | JENNIFER MARIE PENNA |
NPI Number: | 1043544539 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 205 Wakelee Ave Ansonia, CT - 064011234 |
Business Phone Number: | 2037357481 |
Business Fax Number: | |
Mailing Address: | 14 Sheffield Ln, MADISON |
State: | CT |
Postal Code: | 064431770 |
Phone Number: | 2036415929 |
Fax Number: | |
NPI Enumeration Date: | 09/30/2009 |
NPI Last Update Date: | 09/30/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |