| NPI | 1538729926 |
|---|---|
| Former Name | JESSICA CAMPBELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6451020861) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: MI 6362002944) |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2024-03-28 |