| NPI | 1508368564 |
|---|---|
| Former Name | NINA SHAREE JEFFERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 172V00000X Community Health Worker |
| 175T00000X Peer Specialist | |
| 374K00000X | |
| Enumeration Date | 2018-03-06 |
| Last Update Date | 2022-07-21 |