| NPI | 1275047854 |
|---|---|
| Former Name | JESSICA THERRIAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 6458) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: RI MHC00875) |
| Enumeration Date | 2017-11-19 |
| Last Update Date | 2017-11-19 |