Provider Demographics
NPI:1457020851
Name:DIDINO, JENNIFER (NAVIGATOR)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:DIDINO
Suffix:
Gender:F
Credentials:NAVIGATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E BROAD ST STE 300
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2891
Mailing Address - Country:US
Mailing Address - Phone:800-805-6989
Mailing Address - Fax:864-558-8511
Practice Address - Street 1:4 MURRAY GROVE LN
Practice Address - Street 2:
Practice Address - City:LANOKA HARBOR
Practice Address - State:NJ
Practice Address - Zip Code:08734-2837
Practice Address - Country:US
Practice Address - Phone:800-805-6989
Practice Address - Fax:864-558-8511
Is Sole Proprietor?:No
Enumeration Date:2021-09-09
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker