| NPI | 1174588800 |
|---|---|
| Former Name | JENNIFER GREEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NH 1118) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NH 1118) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2007-07-08 |