| NPI | 1285979377 |
|---|---|
| Former Name | JENNA MARIE LIECHTY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18003771A) |
| Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: IN 18003771A) |
| 152W00000X Optometrist (Licence: TN 3035) | |
| 152WV0400X Optometrist, Vision Therapy (Licence: IN 18003771A) | |
| Enumeration Date | 2012-11-30 |
| Last Update Date | 2019-02-20 |