Individual
JENNIFER FANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
950 CAMPBELL AVE, NATIONAL CENTER FOR PTSD (116A), WEST HAVEN, CT 06516-2770
(504) 710-5073
Mailing address
950 CAMPBELL AVE, NATIONAL CENTER FOR PTSD (116A), WEST HAVEN, CT 06516-2770
(504) 710-5073
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
06/14/2011
Last updated
06/14/2011
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