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Individual

MRS. CHRISTINE ANN JENKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, LPC

Contact information

Practice address
615 N 6TH ST, SHEBOYGAN, WI 53081-4612
(810) 355-6178
Mailing address
194 LEXINGTON CT, SHEBOYGAN FALLS, WI 53085-3327
(810) 355-6178

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4573-125
WI
101YP2500X
Professional Counselor
6401002776
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1017382
MCLAREN
MI
01
34930
HEALTH PLAN OF MICHIGAN
MI
01
362835
MANAGED HEALTH NETWORK
MI
Enumeration date
01/05/2006
Last updated
12/20/2012
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