NPI | 1194995027 |
---|---|
Former Name | JACLYN PENTECOST |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WA LH60603740) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 63826) |
Enumeration Date | 2008-03-06 |
Last Update Date | 2023-09-06 |