Individual
KELLY NICHOLE JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1585 3RD ST, FORT JOHNSON, LA 71459-5102
(910) 336-8721
Mailing address
158 STOUT LN, HINESVILLE, GA 31313-5799
(910) 336-8721
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.027203
IL
Other
Enumeration date
05/20/2024
Last updated
10/17/2024
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