| NPI | 1730544495 |
|---|---|
| Former Name | ERIN JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180010498) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 178007961) |
| Enumeration Date | 2015-12-23 |
| Last Update Date | 2016-12-27 |