| 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 | 2007-07-08 |