| NPI | 1417254004 |
|---|---|
| Former Name | JALISSA SHELBY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180014119) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2011-02-17 |
| Last Update Date | 2024-05-07 |