| NPI | 1205764065 |
|---|---|
| Former Name | JENNA PHIPPS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN 1194195248) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 1174477350) |
| 101YP2500X Counselor, Professional (Licence: MN 1164121976) | |
| 103T00000X Psychologist (Licence: MN 1972084226) | |
| 103TC0700X Psychologist, Clinical (Licence: MN 1962955302) | |
| 1041C0700X Social Worker, Clinical (Licence: MN 1962152827) | |
| Enumeration Date | 2026-05-12 |
| Last Update Date | 2026-05-12 |