Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | ||
N | 101YM0800X | Mental Health Counselor | ||
N | 101YP1600X | Pastoral Counselor |
NPI | 1366874075 |
---|---|
Provider Name | Mrs. Valerie Lowe Jenkins |
First Address | Jackson, MS 39204-2046 |
Second Address | Jackson, MS 39204-2046 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2013 |
Last Update Date | 10/07/2014 |