Provider Demographics
NPI:1790488393
Name:MINOR, JENNIFER M V (LAC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M V
Last Name:MINOR
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 COACHMANS TRL
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-9411
Mailing Address - Country:US
Mailing Address - Phone:907-351-1521
Mailing Address - Fax:
Practice Address - Street 1:201 CHARLOTTE ST
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-1415
Practice Address - Country:US
Practice Address - Phone:828-338-9326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-23
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171400000X
NC702171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No171400000XOther Service ProvidersHealth & Wellness Coach