Individual
CHARMAINE MCFADDEN JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1417 E JOHNSON ST, PHILADELPHIA, PA 19138-1107
(215) 866-6651
Mailing address
1417 E JOHNSON ST, PHILADELPHIA, PA 19138-1107
(215) 866-6651
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
103K00000X
Behavior Analyst
—
—
Other
Enumeration date
08/15/2014
Last updated
08/15/2014
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