Provider Demographics
NPI:1053895797
Name:JENNINGS, TAMMYRIA (MS)
Entity type:Individual
Prefix:MS
First Name:TAMMYRIA
Middle Name:
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:TAMMYRIA
Other - Middle Name:
Other - Last Name:JENNINGS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8003 REAGAN CIR
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-2828
Mailing Address - Country:US
Mailing Address - Phone:706-288-8795
Mailing Address - Fax:
Practice Address - Street 1:8003 REAGAN CIR
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-2828
Practice Address - Country:US
Practice Address - Phone:706-288-8795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor