| NPI | 1467809053 |
|---|---|
| Former Name | JENNIFER LYNN ANDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: RI MHC01054) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: CT 006960) |
| 225C00000X Rehabilitation Counselor (Licence: 00233417) | |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2025-04-10 |