Provider Demographics
NPI:1831641125
Name:JENNINGS, MELANIE EVE (MS)
Entity type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:EVE
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:MELANIE
Other - Middle Name:EVE
Other - Last Name:HOFFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:8402 THEODOLITE DR
Mailing Address - Street 2:APT 517
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-8431
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17 E GENESEE ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-4040
Practice Address - Country:US
Practice Address - Phone:315-253-9795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-02
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health