Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | IL |
NPI | 1003908187 |
---|---|
Provider Name | Ms. Valerie Ann Jencks |
First Address | Naperville, IL 60563-3177 |
Second Address | Naperville, IL 60563-3177 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 08/07/2007 |