NPI | 1194296459 |
---|---|
Former Name | JESSICA CHAVIE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN 3510) |
Additional Taxonomies | 101Y00000X Counselor (Licence: MN 2014) |
Enumeration Date | 2018-12-16 |
Last Update Date | 2023-10-17 |