| NPI | 1568035525 |
|---|---|
| Former Name | JACEY SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C7786) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OR R6395) |
| Enumeration Date | 2021-07-19 |
| Last Update Date | 2023-12-01 |