| NPI | 1467510594 | 
|---|---|
| Other Name | JEAN WALRATH FERGUSON | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MS 0801) | 
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MS T0307) | 
| Enumeration Date | 2006-12-04 | 
| Last Update Date | 2025-09-11 |