| NPI | 1518219302 |
|---|---|
| Former Name | JENNIFER TRACEY HAWORTH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 10275) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: ME PS1620) |
| 103T00000X Psychologist (Licence: MA 10275) | |
| 103T00000X Psychologist (Licence: NY 024452) | |
| 103TC0700X Psychologist, Clinical (Licence: MA 10275) | |
| Enumeration Date | 2012-10-04 |
| Last Update Date | 2021-10-19 |