NPI | 1558628388 |
---|---|
Former Name | KRYSTIN JENKS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401010403) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2012-04-18 |
Last Update Date | 2018-12-17 |