Individual
AMANDA JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
505 SILHAVY RD, STE 100, VALPARAISO, IN 46383-4461
(219) 464-1234
(219) 464-1235
Mailing address
505 SILHAVY RD, STE 100, VALPARAISO, IN 46383-4461
(219) 464-1234
(219) 464-1235
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
33006469A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33006469A
—
IN
Enumeration date
01/31/2013
Last updated
03/30/2017
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