NPI | 1427474253 |
---|---|
Former Name | JESSICA MARIE KENNEDY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC010423) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA PCCI3527) |
Enumeration Date | 2014-03-18 |
Last Update Date | 2023-01-26 |