Provider Demographics
NPI:1871859769
Name:STINNETT, JENNA LYNN (MSW)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:LYNN
Last Name:STINNETT
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2718 SUNRISE BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34982-3513
Mailing Address - Country:US
Mailing Address - Phone:772-528-2234
Mailing Address - Fax:
Practice Address - Street 1:2718 SUNRISE BLVD
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34982-3513
Practice Address - Country:US
Practice Address - Phone:772-528-2234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-05
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical