| NPI | 1659439628 |
|---|---|
| Former Name | JESSICA ALYCE BISSEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20042096A) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IN 20042096) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2023-06-01 |