NPI | 1265746390 |
---|---|
Former Name | JESSICA JOTTNIECE RUSH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 71395) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 28633) |
Enumeration Date | 2010-07-30 |
Last Update Date | 2022-09-14 |