NPI | 1609205996 |
---|---|
Former Name | JENNIFER MARIE THOMAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 178.009373) |
Enumeration Date | 2013-11-06 |
Last Update Date | 2024-12-09 |