| NPI | 1073961512 |
|---|---|
| Former Name | JESSICA WEEDEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW006871) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2025-08-04 |