Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist |
NPI | 1225340524 |
---|---|
Provider Name | Amber Jennings |
First Address | Arkansas City, KS 67005-1969 |
Second Address | Arkansas City, KS 67005-1969 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2010 |
Last Update Date | 02/07/2010 |