Individual
MS. NICOLE T JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPH, MA, LAPC, LPMT
Contact information
Practice address
1401 CHEROKEE TRL, CONLEY, GA 30288-1818
(470) 792-5971
Mailing address
PO BOX 372561, DECATUR, GA 30037-2561
(470) 792-5971
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
APC010174
GA
225A00000X
Music Therapist
MUT000131
GA
Other
Enumeration date
02/12/2025
Last updated
02/18/2025
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