| NPI | 1972878338 | 
|---|---|
| Former Name | JENNA LEANN KRUEGER | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C4589) | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: OR R3309) | 
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 13-12-23) | |
| Enumeration Date | 2012-03-19 | 
| Last Update Date | 2021-12-27 |