| NPI | 1306354899 |
|---|---|
| Former Name | JESSICA PETITT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 405936) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 652620) |
| Enumeration Date | 2018-01-18 |
| Last Update Date | 2024-06-03 |