| NPI | 1730717448 |
|---|---|
| Former Name | JACQUELINE WELLS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 16915) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-2686) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2020-03-29 |
| Last Update Date | 2024-11-06 |