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 |