| NPI | 1205207750 |
|---|---|
| Former Name | RHONDA LYNN JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 39002765A) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 88000038A) |
| Enumeration Date | 2015-10-09 |
| Last Update Date | 2020-02-22 |