| NPI | 1386305167 |
|---|---|
| Former Name | JENNIFER RENEE DITTRICH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TX 204349) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 88745) |
| Enumeration Date | 2022-01-04 |
| Last Update Date | 2024-08-05 |