NPI | 1063486330 |
---|---|
Former Name | JESSICA A SCHMIDT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: IA 00999) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IA 00999) |
101YM0800X Counselor, Mental Health (Licence: IA 00999) | |
Enumeration Date | 2006-02-14 |
Last Update Date | 2010-06-24 |