| NPI | 1689116543 |
|---|---|
| Former Name | DOUGLAS TRUE JENKINS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 26846) |
| Enumeration Date | 2016-11-09 |
| Last Update Date | 2016-11-09 |