| NPI | 1194024505 |
|---|---|
| Former Name | JESSICA GLASS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-10-7326) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2011-03-24 |
| Last Update Date | 2020-04-23 |