Individual
FATIMA JENNINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
509 HIGHLAND DR, HENRICO, VA 23075-1721
(804) 661-9239
Mailing address
509 HIGHLAND DR, HENRICO, VA 23075-1721
(804) 807-1311
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101YM0800X
—
VA
05
—
921841153
—
VA
Enumeration date
02/28/2023
Last updated
02/28/2023
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