| NPI | 1538711866 |
|---|---|
| Former Name | JESSICA RUDY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: ID LCSW-40380) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2019-07-16 |
| Last Update Date | 2023-11-07 |