Organization
JOHN MARSHALL JENKINS PHD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MARSHALL JENKINS PHD (LICENSED PSYCHOLOGIST)
(706) 766-1937
Entity
Organization
Contact information
Practice address
504 RIVERSIDE PKWY NE STE 110, ROME, GA 30161-2981
(706) 766-1937
Mailing address
PO BOX 441, ROME, GA 30162-0441
(706) 766-1937
(706) 355-6061
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1861443921
NPPES INDIVIDUAL NPI
—
01
—
PSY001194
GEORGIA PSYCHOLOGIST LICENSE
GA
Enumeration date
02/22/2021
Last updated
12/22/2021
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