| NPI | 1073991394 |
|---|---|
| Former Name | JENNIFER ERIN WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA MC 60547904) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP60627320) |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2017-04-25 |