Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | DC | |
N | 103TS0200X | School Psychologist | 1198026 | NJ |
NPI | 1003581349 |
---|---|
Provider Name | Tiffany Catrice Jenkins |
First Address | Alexandria, VA 22305-2651 |
Second Address | Washington, DC 20032-3734 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2021 |
Last Update Date | 30/08/2021 |