NPI | 1700396223 |
---|---|
Former Name | JADA DOVE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NJ 35SI00627600) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 024079) |
Enumeration Date | 2017-10-10 |
Last Update Date | 2021-01-24 |