| NPI | 1194037275 |
|---|---|
| Former Name | JACQUELYN HAMMEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 6401) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15453) |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2024-01-03 |