Provider Demographics
NPI:1225511926
Name:JENNINGS, ERIN MICHELLE (BS, RBT)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:MICHELLE
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:BS, RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:664 POWERS AVE
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36205-4419
Mailing Address - Country:US
Mailing Address - Phone:256-770-7323
Mailing Address - Fax:
Practice Address - Street 1:664 POWERS AVE
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36205-4419
Practice Address - Country:US
Practice Address - Phone:256-770-7323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-18-54424106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician