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Organization
JOHN MARSHALL JENKINS PHD LLC
Active
Organization
JOHN MARSHALL JENKINS PHD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MARSHALL JENKINS PHD (LICENSED PSYCHOLOGIST)
(706) 766-1937
Entity
Organization
Contact information
Practice address
504 RIVERSIDE PKWY NE STE 110, ROME, GA 30161-2981
(706) 766-1937
Mailing address
PO BOX 441, ROME, GA 30162-0441
(706) 766-1937
(706) 355-6061
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1861443921
NPPES INDIVIDUAL NPI
—
01
—
PSY001194
GEORGIA PSYCHOLOGIST LICENSE
GA
Enumeration date
02/22/2021
Last updated
12/22/2021
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