Individual
DR. JENNIFER LYNN CUMMINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CP
Contact information
Practice address
230 E DAY RD STE 160, MISHAWAKA, IN 46545-3463
(574) 271-8222
(574) 271-8896
Mailing address
230 E DAY RD, #160, MISHAWAKA, IN 46545-3463
(574) 271-8222
(574) 271-8896
Taxonomy
Speciality
Code
Description
License number
State
103TF0000X
Family Psychologist
Primary
20041170
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000382360
BCBS PROVIDER NUMBER
IN
05
—
100091430A
—
IN
Enumeration date
03/22/2006
Last updated
09/28/2021
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