| NPI | 1396142972 |
|---|---|
| Former Name | JILLESSA GAMMON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 58312) |
| Additional Taxonomies | 104100000X Social Worker (Licence: TX 58312) |
| Enumeration Date | 2014-11-26 |
| Last Update Date | 2021-02-27 |