NPI | 1598010613 |
---|---|
Other Name | ANNIE ELIZABETH JESSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IA 09056) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IA 001272) |
Enumeration Date | 2012-07-15 |
Last Update Date | 2012-07-15 |