NPI | 1184707929 |
---|---|
Former Name | CHRISTINA MARIE JAKSA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301014641) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301012781) |
Enumeration Date | 2006-10-23 |
Last Update Date | 2024-05-09 |