| NPI | 1689637175 |
|---|---|
| Former Name | BETSY BLUM JACOBS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL PMH1591) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VT 068-0000546) |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2019-03-01 |