| NPI | 1205120532 |
|---|---|
| Former Name | JESSICA LYNN DAMRON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 32985) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2011-06-03 |
| Last Update Date | 2013-02-27 |