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Individual
JESSICA ELLEN EDMUNDS
Active
Individual
JESSICA ELLEN EDMUNDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRC, LPC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC-7034
ID
101YM0800X
Mental Health Counselor
LPC-7034
ID
225C00000X
Rehabilitation Counselor
340617
ID
Other
Enumeration date
11/13/2023
Last updated
11/13/2023
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