| NPI | 1629587050 |
|---|---|
| Former Name | JANA LEE DEISS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WA 60887266) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2017-09-28 |
| Last Update Date | 2019-02-05 |