| NPI | 1689271801 |
|---|---|
| Former Name | JESSICA TESS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 10261) |
| Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: WI 189834-30) |
| Enumeration Date | 2020-10-01 |
| Last Update Date | 2021-06-11 |