| NPI | 1134674971 |
|---|---|
| Former Name | JENELLE MONET DEBEAULIEU |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: VA 0701010840) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF8720) |
| Enumeration Date | 2016-08-22 |
| Last Update Date | 2021-12-29 |