NPI | 1558612010 |
---|---|
Former Name | JESSICA HART BYERLY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC6290) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MD LGP5307) |
101Y00000X Counselor | |
221700000X Art Therapist (Licence: MD ATC139) | |
Enumeration Date | 2012-09-25 |
Last Update Date | 2019-04-23 |