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General NPI Number Information
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NPI Number | 1225822448
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Entity Type | Individual
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Provider Name | MR. ROBERT LASHON JENKINS JR.
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Gender | Male
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Dates
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Enumeration Date | 04/04/2025
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Last Update Date | 04/04/2025
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Provider Practice Location Address
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Address Line | 2795 MAIN ST W
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City | SNELLVILLE
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State | GA
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Zip | 30078-3164
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Country | US
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Telephone | 678-344-7836
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Fax |
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Provider Business Mailing Address
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Address Line | 100 NORTHWOOD CREEK WAY
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City | OXFORD
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State | GA
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Zip | 30054-4642
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Country | US
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Telephone | 943-227-4413
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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