NPI | 1255113445 |
---|---|
Former Name | JESSICA ANN BOATRIGHT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 68220) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 15858) |
Enumeration Date | 2023-10-20 |
Last Update Date | 2023-10-20 |