NPI | 1154507614 |
---|---|
Former Name | JENNIFER L JOHNSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NE 1355) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 959) |
Enumeration Date | 2008-01-15 |
Last Update Date | 2012-06-28 |