Individual
KOLU JENNINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MCAP, CMHP, CBHCMS
Contact information
Practice address
590 ELLIS RD S, JACKSONVILLE, FL 32254-3555
(904) 800-2231
Mailing address
6266 DUPONT STATION CT E, JACKSONVILLE, FL 32217-2567
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
12/30/2016
Last updated
10/24/2022
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