NPI | 1063748705 |
---|---|
Former Name | JENNIFER ROBYN MARTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 7957) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC 7597) |
Enumeration Date | 2009-10-31 |
Last Update Date | 2022-09-21 |