| NPI | 1417296419 |
|---|---|
| Former Name | JESSICA BENES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NE 1572) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NE 1150) |
| Enumeration Date | 2013-02-11 |
| Last Update Date | 2020-01-15 |