| NPI | 1407783129 |
|---|---|
| Former Name | JENSA RAE BAUMGARTNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT BBH-LAC-LIC-78709) |
| Enumeration Date | 2026-05-06 |
| Last Update Date | 2026-05-06 |