| NPI | 1144355546 |
|---|---|
| Former Name | JENNIFER PORTERFIELD HICKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC006102) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AL 2684) |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2011-06-10 |