| NPI | 1063229433 |
|---|---|
| Former Name | JENNIFER BISHOP |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CT 7992) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC A22065) |
| 101YM0800X Counselor, Mental Health (Licence: TX 97697) | |
| Enumeration Date | 2024-12-18 |
| Last Update Date | 2026-01-26 |