| NPI | 1003084369 |
|---|---|
| Former Name | JACQUELINE DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CO RN0188325) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2008-02-20 |
| Last Update Date | 2017-02-10 |