| NPI | 1326232273 |
|---|---|
| Former Name | KYLIE ANNE JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY23167) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2007-09-04 |
| Last Update Date | 2018-05-17 |