| NPI | 1043986334 |
|---|---|
| Former Name | JESSICA SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NM CMH0215611) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2021-08-18 |
| Last Update Date | 2024-05-30 |