| NPI | 1659743805 |
|---|---|
| Former Name | JESSICA SU |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IL 166.001671) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 178.017697) |
| Enumeration Date | 2015-10-28 |
| Last Update Date | 2023-12-12 |