| NPI | 1902228547 |
|---|---|
| Former Name | JENNIFER LYNN RENNICH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ND 838-6-1-15-301) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ND 1701) |
| Enumeration Date | 2014-01-16 |
| Last Update Date | 2019-01-09 |