| NPI | 1659980498 |
|---|---|
| Former Name | JAMIE ROSE HERSTEK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: SC 7696) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: PA PC012448) |
| Enumeration Date | 2020-07-28 |
| Last Update Date | 2023-05-19 |