| NPI | 1396140422 |
|---|---|
| Former Name | JESSICA WOOD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN lp6373) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2014-10-31 |
| Last Update Date | 2019-03-05 |