Provider Demographics
NPI:1114568243
Name:HAZLEWOOD, JENNA (LMFT)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:HAZLEWOOD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 HIGHLAND AVENUE
Mailing Address - Street 2:SUITE 350
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-4009
Mailing Address - Country:US
Mailing Address - Phone:205-558-2525
Mailing Address - Fax:205-558-2554
Practice Address - Street 1:100 PHYSICIANS WAY STE 250
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37090-8105
Practice Address - Country:US
Practice Address - Phone:615-788-1769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-30
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist