| NPI | 1356466825 |
|---|---|
| Former Name | JADE A. MADDOX |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KY 104063) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 0666) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2025-12-04 |