| NPI | 1245689678 |
|---|---|
| Former Name | JENNIFER NICOLE VANCOUR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR A14776) |
| Additional Taxonomies | 104100000X Social Worker (Licence: ID 35800) |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2024-01-25 |