| NPI | 1689971541 |
|---|---|
| Former Name | JENNIFER DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071008531) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IL 071-008531) |
| Enumeration Date | 2011-02-11 |
| Last Update Date | 2022-09-20 |