NPI | 1215569991 |
---|---|
Former Name | JESSICA LYNN PEPPLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401223466) |
Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6401223466) |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2020-02-10 |
Last Update Date | 2024-02-15 |