| NPI | 1144532078 |
|---|---|
| Former Name | JESSICA ANN ROMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 5624) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional (Licence: NC 9517) | |
| 101Y00000X Counselor | |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2016-01-16 |