Individual
NICOLE JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
420 NW 2ND ST, CORVALLIS, OR 97330-6442
(541) 286-5487
Mailing address
420 NW 2ND ST, CORVALLIS, OR 97330-6442
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
03075
KS
Other
Enumeration date
09/18/2018
Last updated
06/21/2022
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