Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | ||
N | 103TB0200X | Cognitive & Behavioral Psychologist | ||
N | 103G00000X | Clinical Psychologist | 2037 | NC |
N | 103TC0700X | Clinical Psychologist | 2037 | NC |
N | 103TF0000X | Family Psychologist | ||
N | 103TP2701X | Group Psychotherapist |
NPI | 1134346158 |
---|---|
Provider Name | Dr. David E. Jenkins |
First Address | Lynchburg, VA 24503-3604 |
Second Address | Lynchburg, VA 24502-2269 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2007 |
Last Update Date | 08/07/2007 |