Doctor Name: | MR. ROLAND LEON JENNINGS |
NPI Number: | 1366741761 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW-C |
License Number: | 18340 |
Business Practice Address: | 12145 Elm St Princess Anne, MD - 218531358 |
Business Phone Number: | 4106512204 |
Business Fax Number: | 4106510790 |
Mailing Address: | Po Box 1978, SALISBURY |
State: | MD |
Postal Code: | 218021978 |
Phone Number: | 4107491015 |
Fax Number: | 4107490654 |
NPI Enumeration Date: | 03/24/2011 |
NPI Last Update Date: | 03/11/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 18340 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |