NPI | 1346598133 |
---|---|
Former Name | JESSICA M JOSEPH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA 25954) |
Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: CA 25954) |
Enumeration Date | 2012-08-27 |
Last Update Date | 2020-01-07 |