| NPI | 1639540073 |
|---|---|
| Former Name | JESICA KOSSA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801104075) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6801098585) |
| Enumeration Date | 2015-10-12 |
| Last Update Date | 2025-01-15 |