| NPI | 1003268152 |
|---|---|
| Former Name | JESSICA LYN THOMPSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2022043250) |
| Enumeration Date | 2016-07-12 |
| Last Update Date | 2022-11-01 |