NPI | 1194363127 |
---|---|
Former Name | JENNIFER BERNIECE HUBBARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KS 078) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MO 2000150520) |
Enumeration Date | 2019-12-20 |
Last Update Date | 2019-12-20 |