NPI | 1326317041 |
---|---|
Former Name | JESSICA SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY11842) |
Additional Taxonomies | 101Y00000X Counselor |
Enumeration Date | 2011-12-27 |
Last Update Date | 2023-06-14 |