Individual
DR. CHRISTINE JO JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
406 N MAIN ST, LA FAYETTE, GA 30728-2424
(706) 638-2339
(706) 638-7400
Mailing address
PO BOX 1085, LA FAYETTE, GA 30728-1085
(706) 638-2339
(706) 638-7400
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
001559
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00484811C
—
GA
Enumeration date
10/12/2009
Last updated
10/12/2009
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