| NPI | 1225212178 |
|---|---|
| Former Name | JESSICA ANN RIESTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 076052) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: AZ 21395) |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2023-07-28 |