NPI | 1174034110 |
---|---|
Former Name | JESSICA PEMBERTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103K00000X Behavior Analyst |
Additional Taxonomies | 101YM0800X Counselor Mental Health |
Enumeration Date | 2017-10-17 |
Last Update Date | 2024-08-05 |