NPI | 1740691351 |
---|---|
Former Name | JESSICA GAIL KONKLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH61027977) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA MC60799054) |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2014-05-16 |
Last Update Date | 2023-03-29 |