NPI | 1154506053 |
---|---|
Former Name | JESSICA NANCE D. PARKER, MITCHELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 5696) |
Additional Taxonomies | 101YP2500X Counselor, Professional |
Enumeration Date | 2008-01-09 |
Last Update Date | 2012-06-20 |