NPI | 1427212828 |
---|---|
Former Name | JAMIE LYN MOORE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 103T00000X Psychologist (Licence: CA 23913) |
Enumeration Date | 2008-07-15 |
Last Update Date | 2021-09-03 |