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 |