Individual
MS. JENNY MARI WOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
163 APPLE LN, JASPER, GA 30143-4672
(770) 833-1055
Mailing address
163 APPLE LN, JASPER, GA 30143-4672
(770) 833-1055
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
005044
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005044
LICENSED PROFESSIONAL COUNSELOR
GA
Enumeration date
12/11/2020
Last updated
12/11/2020
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