NPI | 1659731834 |
---|---|
Former Name | JENNA LEANN SHAW |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AL 3946) |
Enumeration Date | 2016-03-01 |
Last Update Date | 2025-03-06 |