| NPI | 1144661935 |
|---|---|
| Former Name | JESSICA L JENNINGS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: VA 0701004672) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: VA 0701004672) |
| Enumeration Date | 2013-07-10 |
| Last Update Date | 2013-07-10 |