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Individual

MR. CHARLES LEONARD JENNINGS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMSW CASAC

Contact information

Practice address
1603 CHESTER ST, BRONX, NY 10469-2679
(917) 574-8796
Mailing address
1603 CHESTER ST, BRONX, NY 10469-2679
(917) 574-8796

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
081324
NY

Other

Enumeration date
10/04/2022
Last updated
10/04/2022
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