Provider Demographics
NPI:1033993852
Name:DAVIS, JENNIFER LYNN (TMFT)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:LYNN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:TMFT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:LINENBERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 E LINCOLN ST STE G
Mailing Address - Street 2:
Mailing Address - City:LINDSBORG
Mailing Address - State:KS
Mailing Address - Zip Code:67456-2406
Mailing Address - Country:US
Mailing Address - Phone:785-643-1115
Mailing Address - Fax:
Practice Address - Street 1:201 E LINCOLN ST STE G
Practice Address - Street 2:
Practice Address - City:LINDSBORG
Practice Address - State:KS
Practice Address - Zip Code:67456-2406
Practice Address - Country:US
Practice Address - Phone:785-643-1115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist