NPI | 1053161638 |
---|---|
Former Name | VIRGINIA JACOBS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TS0200X Psychologist, School (Licence: TN 3924) |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: TN 3924) |
Enumeration Date | 2024-03-25 |
Last Update Date | 2024-09-26 |