Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | GA | |
N | 174V00000X | Clinical Ethicist | GA |
NPI | 1568934933 |
---|---|
Provider Name | Dr. Melissa R Jenkins |
First Address | Hinesville, GA 31313-7055 |
Second Address | Hinesville, GA 31313-7055 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/12/2018 |
Last Update Date | 08/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CSC2689 | CERTIFIED PASTORAL COUNSELOR (01) | GA |
D.PSC | DOCTOR OF PASTORAL SCIENCE & MEDICINE (01) | TX |
GA2689HHC | HOLISTIC HEALTH COACH (01) | GA |
PCT2689 | PATIENT CARE SPEACIALIST (01) | GA |