| NPI | 1205484540 |
|---|---|
| Former Name | JESSICA NICOLE MAYFIELD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801115431) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MI 6801108109) |
| 1041C0700X Social Worker Clinical (Licence: MI 6851108109) | |
| Enumeration Date | 2019-08-29 |
| Last Update Date | 2024-05-06 |