| NPI | 1720312028 |
|---|---|
| Former Name | JENNIFER CLARK BOUWKAMP-MEMMER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IN 20042856A) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MO 2008034834) |
| Enumeration Date | 2009-09-21 |
| Last Update Date | 2022-07-21 |