| Dr Jenny Llc | |
|
2208 Avonlea Way Gainesville GA 30504-2682 | |
| (770) 540-9084 | |
| Not Available |
| Full Name | Dr Jenny Llc |
|---|---|
| Speciality | Counselor |
| Location | 2208 Avonlea Way, Gainesville, Georgia |
| Authorized Official Name and Position | Jenny Heuer (OWNER) |
| Authorized Official Contact | 7705409084 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jenny Llc 2208 Avonlea Way Gainesville GA 30504-2682 Ph: (770) 540-9084 | Dr Jenny Llc 2208 Avonlea Way Gainesville GA 30504-2682 Ph: (770) 540-9084 |
| NPI Number | 1003558529 |
|---|---|
| Provider Enumeration Date | 04/13/2022 |
| Last Update Date | 12/20/2022 |
| Certification Date | 12/20/2022 |
| Medicare PECOS PAC ID | 5092159681 |
|---|---|
| Medicare Enrollment ID | O20240222002145 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003558529 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Jenny Heuer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487161899 PECOS PAC ID: 5294178109 Enrollment ID: I20240207004110 |
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