| NPI | 1609022029 |
|---|---|
| Former Name | JESSICA RENEE WILEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C008048) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TX 103893) |
| 1041C0700X Social Worker, Clinical (Licence: LA 8570) | |
| 1041C0700X Social Worker, Clinical (Licence: FL SW15676) | |
| 1041C0700X Social Worker, Clinical (Licence: ME LC17354) | |
| 1041C0700X Social Worker, Clinical (Licence: AZ 20261) | |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2024-07-23 |