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Individual

DR. JENNIFER E FENNELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSYD

Contact information

Practice address
4530 SOUTH BERKELEY LAKE ROAD, NORCROSS, GA 30071
(770) 446-5642
(770) 446-5643
Mailing address
4530 SOUTH BERKELEY LAKE ROAD, NORCROSS, GA 30071
(770) 446-5642
(770) 446-5643

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY003407
GA

Other

Enumeration date
12/27/2011
Last updated
12/27/2011
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