| NPI | 1154768729 |
|---|---|
| Former Name | JESSICA LAUREN BUCKLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2013-05-22 |
| Last Update Date | 2013-05-22 |