| NPI | 1316223225 |
|---|---|
| Former Name | JESSICA FAITH CONWAY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: KS 05761) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OK 4212) |
| 1041C0700X Social Worker Clinical (Licence: OK 5065) | |
| Enumeration Date | 2011-10-25 |
| Last Update Date | 2022-09-29 |