Individual
JENNIFER NORA WATERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, ATR, LPCC, LMHC
Contact information
Practice address
3719 TULLY RD STE A1, MODESTO, CA 95356-1026
(209) 900-1167
Mailing address
3719 TULLY RD STE A1, MODESTO, CA 95356-1026
(209) 900-1167
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
07/20/2011
Last updated
02/26/2021
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