Provider Demographics
NPI:1518010529
Name:HOLLANDER, JENNIFER KENNEY (PHD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:KENNEY
Last Name:HOLLANDER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 472
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70404-0472
Mailing Address - Country:US
Mailing Address - Phone:985-634-7594
Mailing Address - Fax:225-209-1291
Practice Address - Street 1:216 W THOMAS ST
Practice Address - Street 2:SUITE 4
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70401-3263
Practice Address - Country:US
Practice Address - Phone:985-634-7594
Practice Address - Fax:225-209-1291
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA894101YA0400X
LA2299101YP2500X
LA131106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist