NPI | 1356681423 |
---|---|
Former Name | JESSICA JEAN SIERZCHULA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 83681) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0102203965) |
Enumeration Date | 2013-02-26 |
Last Update Date | 2021-06-30 |