NPI | 1134574957 |
---|---|
Former Name | JESSICA L WORLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 74256) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036155200) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-04-29 |
Last Update Date | 2023-08-29 |