| NPI | 1740425461 |
|---|---|
| Former Name | JENNA LEA KIMBROUGH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TN 2356) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TN 2356) |
| Enumeration Date | 2008-12-09 |
| Last Update Date | 2016-07-14 |