Provider Demographics
NPI:1801340328
Name:MCDONNELL, JENNIFER LORRAINE (BS)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LORRAINE
Last Name:MCDONNELL
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3321 SAINT MARTIN LN
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-4628
Mailing Address - Country:US
Mailing Address - Phone:407-360-5231
Mailing Address - Fax:
Practice Address - Street 1:3321 SAINT MARTIN LN
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-4628
Practice Address - Country:US
Practice Address - Phone:407-360-5231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-12
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor