| 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 | 2024-03-25 |