| 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 |