| NPI | 1376718130 |
|---|---|
| Former Name | JENNIE N MADURA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180.006644) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 180.006644) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2011-04-04 |