Doctor Name: | SHIRELLE S JENKINS |
NPI Number: | 1023315389 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | BA |
License Number: | |
Business Practice Address: | 128 Cross Keys Rd Berlin, NJ - 080099201 |
Business Phone Number: | 8562101500 |
Business Fax Number: | |
Mailing Address: | 19 E Ormond Ave, CHERRY HILL |
State: | NJ |
Postal Code: | 080342053 |
Phone Number: | 8564281300 |
Fax Number: | |
NPI Enumeration Date: | 02/23/2011 |
NPI Last Update Date: | 02/23/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |