Individual
MRS. JENNIFER LYNN TENNESSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SAC-IT
Contact information
Practice address
3301 N BALLARD RD STE B, APPLETON, WI 54911-9002
(920) 851-4468
Mailing address
N472 KILSDONK CT, APPLETON, WI 54915-8726
(920) 851-4468
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
18280-130
WI
Other
Enumeration date
08/11/2018
Last updated
08/11/2018
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