| NPI | 1700143963 |
|---|---|
| Former Name | JESSICA CHRISTINE CYSEWSKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA CAAR.CG.60281252) |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2012-04-12 |