NPI | 1154983146 |
---|---|
Former Name | JADA NICOLE JACKSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 170300000X Genetic Counselor, MS |
Additional Taxonomies | 170300000X Genetic Counselor, MS (Licence: OK 0339) |
Enumeration Date | 2019-07-01 |
Last Update Date | 2020-07-21 |