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Individual

MRS. NICOLE MARIE JENKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, LMFT

Contact information

Practice address
4045 LAKE OTIS PKWY, ANCHORAGE, AK 99508-5227
(907) 561-0954
Mailing address
PO BOX 2447, PALMER, AK 99645-2447
(530) 270-9072

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
106H00000X
Marriage & Family Therapist
Primary
270
AK
106H00000X
Marriage & Family Therapist
52743
CA
106H00000X
Marriage & Family Therapist
62465
CA

Other

Enumeration date
02/25/2008
Last updated
05/08/2019
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