| NPI | 1437711371 |
|---|---|
| Former Name | STACIE JENKINS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 175T00000X Peer Specialist |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2019-07-01 |
| Last Update Date | 2022-10-05 |