NPI | 1225297609 |
---|---|
Former Name | JESSICA LEIGH MACAULAY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: CA PSB94021710) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2008-06-02 |
Last Update Date | 2016-02-26 |