| NPI | 1063485233 |
|---|---|
| Former Name | JESSICA N. KING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CO 165) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CO 6093) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2020-02-05 |