| NPI | 1275908675 |
|---|---|
| Former Name | JAZMYN WILBANKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 7237-125) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 2783-226) |
| Enumeration Date | 2015-12-10 |
| Last Update Date | 2024-10-09 |