| NPI | 1669867446 |
|---|---|
| Former Name | JESSICA JENKINS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC-15686) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LAC-13921) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2016-01-12 |