| NPI | 1053731018 |
|---|---|
| Former Name | JESSICA MARIE VALENCIA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TX 38205) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA D4627793) |
| Enumeration Date | 2014-04-17 |
| Last Update Date | 2021-08-16 |