NPI | 1144661935 |
---|---|
Former Name | JESSICA L JENNINGS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701004672) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0701004672) |
Enumeration Date | 2013-07-10 |
Last Update Date | 2013-07-10 |