Provider Demographics
NPI:1396405460
Name:DUNNING, JENNA ANNE (LSW)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:ANNE
Last Name:DUNNING
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1048 PENNSYLVANIA AVE W
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:PA
Mailing Address - Zip Code:16365-1838
Mailing Address - Country:US
Mailing Address - Phone:814-230-9111
Mailing Address - Fax:814-313-1075
Practice Address - Street 1:1048 PENNSYLVANIA AVE W
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:PA
Practice Address - Zip Code:16365-1838
Practice Address - Country:US
Practice Address - Phone:814-230-9111
Practice Address - Fax:814-313-1075
Is Sole Proprietor?:No
Enumeration Date:2021-12-30
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW138887104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker