| NPI | 1720471378 |
|---|---|
| Former Name | JACQUELYN RAYMOND |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: ME CC5072) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: ME XL4381) |
| 221700000X Art Therapist (Licence: ME 17-064) | |
| Enumeration Date | 2015-03-06 |
| Last Update Date | 2020-05-06 |