| NPI | 1548797459 |
|---|---|
| Former Name | JESSICA GRAHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 81098) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: VA 0133002370) |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2022-03-15 |