NPI | 1104422302 |
---|---|
Former Name | JESSICA MONTANO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: M-11870) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NM X-11743) |
Enumeration Date | 2020-12-11 |
Last Update Date | 2024-06-25 |