| NPI | 1104012574 |
|---|---|
| Former Name | JENNIFER NICOLE WEADE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CO MFT.0001222) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2023-05-15 |