Doctor Name: | MS. SHANNON LEIGH JENNINGS |
NPI Number: | 1073897500 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 65191 |
Business Practice Address: | 101 Executive Ct Waxahachie, TX - 751651970 |
Business Phone Number: | 9729239214 |
Business Fax Number: | |
Mailing Address: | 631 Oliver Ln, WAXAHACHIE |
State: | TX |
Postal Code: | 751654484 |
Phone Number: | 8178794397 |
Fax Number: | |
NPI Enumeration Date: | 10/03/2011 |
NPI Last Update Date: | 10/03/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 65191 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |