| NPI | 1033565833 |
|---|---|
| Former Name | JENNIFER LEE JEZIORSKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 38062) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071008255) |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2018-12-19 |