Provider Demographics
NPI:1033275011
Name:SPEIGHTS, JENNIFER MARIA (MED)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:MARIA
Last Name:SPEIGHTS
Suffix:
Gender:F
Credentials:MED
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Mailing Address - Street 1:3891 BELMONT RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-4077
Mailing Address - Country:US
Mailing Address - Phone:770-808-8439
Mailing Address - Fax:770-808-3772
Practice Address - Street 1:595 OLD NORCROSS RD STE B
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30045-7667
Practice Address - Country:US
Practice Address - Phone:770-995-6901
Practice Address - Fax:770-995-6958
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health