Individual
MS. ANIEZKA M JENISSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC, CDP
Contact information
Practice address
922 FIR ST, LONGVIEW, WA 98632-2525
(360) 353-9422
Mailing address
PO BOX 2429, LONGVIEW, WA 98632-8486
(360) 353-9494
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CP60067928
WA
101YM0800X
Mental Health Counselor
Primary
LH60706894
WA
Other
Enumeration date
11/14/2006
Last updated
01/06/2017
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