NPI | 1053651828 |
---|---|
Former Name | JENNIFER LYNN GEDDES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SC 7293) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: SC 8040) |
101YM0800X Counselor, Mental Health (Licence: NC 9587) | |
Enumeration Date | 2013-02-15 |
Last Update Date | 2024-05-09 |