| NPI | 1043435092 |
|---|---|
| Former Name | JODI VANESSA CREAGER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 68021) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NM 0123831) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2011-09-07 |