| NPI | 1730705674 |
|---|---|
| Former Name | MAURA JENKINS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: MD 06413) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2020-06-16 |
| Last Update Date | 2022-09-14 |