| NPI | 1104269018 |
|---|---|
| Other Name | JESSE LAUREL VICE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 5030) |
| Additional Taxonomies | 104100000X Social Worker (Licence: KY 6365) |
| 106H00000X Marriage & Family Therapist (Licence: KY 2012-028) | |
| Enumeration Date | 2013-04-10 |
| Last Update Date | 2025-10-30 |