Individual
MS. ALYSSA MARY JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14 MANLY ST, GREENVILLE, SC 29601
(864) 634-4876
Mailing address
14 MANLY ST, GREENVILLE, SC 29601-3023
(864) 634-4876
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
Primary
6902
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
301100
—
SC
Enumeration date
05/18/2016
Last updated
08/14/2018
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