Provider Demographics
NPI:1689798316
Name:CIOLLI, JENNY LYNN
Entity Type:Individual
Prefix:MS
First Name:JENNY
Middle Name:LYNN
Last Name:CIOLLI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 E SPRAGUE AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-1534
Mailing Address - Country:US
Mailing Address - Phone:509-343-5004
Mailing Address - Fax:
Practice Address - Street 1:210 E SPRAGUE AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1534
Practice Address - Country:US
Practice Address - Phone:509-343-5004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00054178101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WARC00054178OtherREGISTERED COUNSELOR