| NPI | 1578983854 | 
|---|---|
| Former Name | JESSICA MARIE RICHARDSON | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: VA 0102205632)  | 
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0102205632)  | 
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA Os019421)  | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: PA oSo19421)  | |
| Enumeration Date | 2014-04-24 | 
| Last Update Date | 2020-01-12 |