| NPI | 1538106331 |
|---|---|
| Former Name | JILL SQUYRES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 3711) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TX 24177) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2021-11-16 |