Doctor Name: | JENNY PRESTON |
NPI Number: | 1043675937 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.ED., LPC |
License Number: | 1400679 |
Business Practice Address: | 151 S Market St Suite 201 Wooster, OH - 446914872 |
Business Phone Number: | 3303179276 |
Business Fax Number: | |
Mailing Address: | 3574 Melrose Dr, Unit K6 WOOSTER |
State: | OH |
Postal Code: | 446911857 |
Phone Number: | 3303179276 |
Fax Number: | |
NPI Enumeration Date: | 12/21/2015 |
NPI Last Update Date: | 12/21/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 1400679 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |