NPI | 1649337445 |
---|---|
Former Name | JESSICA LEIGH PROKASH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH00011027) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WA RC00050490) |
Enumeration Date | 2007-01-02 |
Last Update Date | 2008-10-22 |