| NPI | 1689177594 |
|---|---|
| Former Name | JASMINE MONIQUE FULP |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 13832) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 26592-A) |
| Enumeration Date | 2018-03-16 |
| Last Update Date | 2023-08-03 |