| NPI | 1487383295 |
|---|---|
| Former Name | MARY JANE NONE LESSARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ 10652) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ 15474) |
| Enumeration Date | 2022-06-07 |
| Last Update Date | 2022-06-07 |