| NPI | 1477091361 |
|---|---|
| Former Name | JENNIFER CHRISTINE SHADE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 115271) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2017-02-10 |
| Last Update Date | 2022-08-08 |