| NPI | 1306072087 |
|---|---|
| Former Name | JESSICA RAE HANSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401011082) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MI 4101006406) |
| Enumeration Date | 2009-06-08 |
| Last Update Date | 2009-10-26 |