NPI | 1336185719 |
---|---|
Former Name | JILL LYNN WILEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC000718) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: PA PC-000718) |
Enumeration Date | 2006-06-22 |
Last Update Date | 2017-05-09 |