| NPI | 1104335645 |
|---|---|
| Former Name | JENNIFER MICHELLE MAYO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NJ 355100584900) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NJ 35SI00584900) |
| Enumeration Date | 2017-09-27 |
| Last Update Date | 2018-07-05 |