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General NPI Number Information
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NPI Number | 1518608280
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Entity Type | Individual
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Provider Name | TONIQUA D JENNINGS
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Gender | Female
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Dates
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Enumeration Date | 04/05/2022
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Last Update Date | 04/05/2022
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Provider Practice Location Address
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Address Line | 1027 SHERRICK RD SE
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City | CANTON
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State | OH
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Zip | 44707-3506
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Country | US
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Telephone | 330-313-0270
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Fax |
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Provider Business Mailing Address
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Address Line | 4786 DRESSLER RD NW # 318
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City | CANTON
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State | OH
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Zip | 44718-2555
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Country | US
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Telephone | 234-521-0822
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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