| NPI | 1619019890 |
|---|---|
| Former Name | JEANA TATE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TN 2545) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2025-01-28 |