| NPI | 1336415637 |
|---|---|
| Other Name | JACKIE CAMP |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 5082) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IN 20042737A) |
| 103TC0700X Psychologist Clinical (Licence: IN 20042737A) | |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2021-02-05 |