Individual
JENESSE RAE QUAN AQUINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHCA
Contact information
Practice address
4109 BRIDGEPORT WAY W STE C, UNIVERSITY PLACE, WA 98466-4328
(808) 517-1590
Mailing address
4109 BRIDGEPORT WAY W STE C, UNIVERSITY PLACE, WA 98466-4328
(808) 517-1590
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
MC61472064
WA
Other
Enumeration date
08/25/2023
Last updated
08/25/2023
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