Provider Demographics
NPI:1801529847
Name:JENNINGS, ADRIENNE HOLLAND
Entity type:Individual
Prefix:MS
First Name:ADRIENNE
Middle Name:HOLLAND
Last Name:JENNINGS
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 1:3029 FALCON CREEK DR APT SUITE
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23231-1842
Mailing Address - Country:US
Mailing Address - Phone:804-721-7866
Mailing Address - Fax:
Practice Address - Street 1:3029 FALCON CREEK DR APT SUITE
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23231-1842
Practice Address - Country:US
Practice Address - Phone:804-721-7866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-07
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
VA0701012524101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional