| NPI | 1073784211 |
|---|---|
| Former Name | JENNY MARIE MATHEWS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2008-03-16 |
| Last Update Date | 2022-07-21 |