NPI | 1225345077 |
---|---|
Former Name | JAYDE KENNEDY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301016332) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2010-08-31 |
Last Update Date | 2016-08-29 |