Provider Information for 1821360231
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MICHAEL EDWARD JENKINS LMFT
Sex: Male
NPI: 1821360231
Last Updated: 2012-06-26
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1821360231 | ||||||||
| Enumeration Date | 2012-01-31 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1061 HARMON AVE STE 1D03 FORT STEWART, GA 31314-5641 United States Phone: 912-435-6633 | Fax: | ||||||||
| Primary Practice Address | 1061 HARMON AVE STE 1D03 FORT STEWART, GA 31314-5641 United States Phone: 912-435-6633 | Fax: | ||||||||
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