| NPI | 1063912921 |
|---|---|
| Former Name | DEONDRA JACOBS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MD 05785) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent |
| Enumeration Date | 2018-02-17 |
| Last Update Date | 2025-07-31 |