| NPI | 1164891941 |
|---|---|
| Former Name | JESSICA FAE GOLDEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: LA 11620) |
| Enumeration Date | 2015-09-22 |
| Last Update Date | 2022-07-21 |