| NPI | 1568599157 |
|---|---|
| Former Name | JODY R MCKOON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34005828A) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2020-12-02 |