Individual
JENNIFER PENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6504 ALTA DR, LAS VEGAS, NV 89107-3304
(661) 470-1787
Mailing address
6504 ALTA DR, LAS VEGAS, NV 89107-3304
(661) 470-1787
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/26/2016
Last updated
10/26/2016
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