NPI | 1639418627 |
---|---|
Former Name | JENA GARRICK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NV py1089) |
Additional Taxonomies | 103T00000X Psychologist (Licence: NV PY1089) |
103TB0200X Psychologist, Cognitive & Behavioral | |
103TP2701X Psychologist, Group Psychotherapy | |
Enumeration Date | 2013-02-11 |
Last Update Date | 2022-12-14 |