| NPI | 1144769043 |
|---|---|
| Former Name | JESSICA YARBROUGH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WI 2264-226) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 17188-130) |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2017-02-13 |