Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | ||
N | 101YP1600X | Pastoral Counselor | ||
N | 101YP2500X | Professional Counselor |
NPI | 1336541127 |
---|---|
Provider Name | Aaron S. Jenkins |
First Address | Bay Shore, NY 11706-2623 |
Second Address | Bay Shore, NY 11706-2623 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2014 |
Last Update Date | 23/09/2014 |