NPI | 1609117316 |
---|---|
Former Name | JESSICA A BIBA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 5661-125) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16090-132) |
Enumeration Date | 2013-03-05 |
Last Update Date | 2018-03-06 |