| NPI | 1558400697 |
|---|---|
| Former Name | JILL KRISTINE PETERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 2205) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 378) |
| 101YM0800X Counselor, Mental Health (Licence: NE 395) | |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2024-11-11 |