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General NPI Number Information
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NPI Number | 1245035831
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Entity Type | Individual
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Provider Name | TAYLOR JENNINGS
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Gender | Female
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Dates
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Enumeration Date | 02/17/2025
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Last Update Date | 02/17/2025
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Provider Practice Location Address
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Address Line | 1900 E MILITARY AVE STE 212
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City | FREMONT
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State | NE
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Zip | 68025-5433
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Country | US
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Telephone | 402-214-5641
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Fax |
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Provider Business Mailing Address
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Address Line | 19379 W ST
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City | OMAHA
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State | NE
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Zip | 68135-4257
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Country | US
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Telephone | 402-214-5641
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 14298
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License Number State | NE
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