Provider Demographics
NPI:1407084346
Name:JENNINGS, ARLETHA LYNETTE
Entity Type:Individual
Prefix:MRS
First Name:ARLETHA
Middle Name:LYNETTE
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ARLETHA
Other - Middle Name:JENNINGS
Other - Last Name:JENNINGS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3307 OLNEY RD
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49006-2831
Mailing Address - Country:US
Mailing Address - Phone:269-779-0303
Mailing Address - Fax:
Practice Address - Street 1:3307 OLNEY RD
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49006-2831
Practice Address - Country:US
Practice Address - Phone:269-779-0303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-30
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist