| NPI | 1174931828 |
|---|---|
| Former Name | JESSICA MARIA MCCONVILLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: NC C010575) |
| Additional Taxonomies | 104100000X Social Worker (Licence: TN 10157) |
| 1041C0700X Social Worker, Clinical (Licence: NC C010575) | |
| Enumeration Date | 2014-07-25 |
| Last Update Date | 2023-09-08 |