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Individual

MR. DOUGLAS TRUE JENKINS I

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CASAC

Contact information

Practice address
5714 FARRAGUT RD, BROOKLYN, NY 11234-1346
(718) 840-9982
Mailing address
5714 FARRAGUT RD, BROOKLYN, NY 11234-1346
(718) 840-9982

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
26846
NY

Other

Enumeration date
11/09/2016
Last updated
11/09/2016
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