NPI | 1750637401 |
---|---|
Former Name | JAMIE LYNNE WARGO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC013633) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH17585) |
Enumeration Date | 2012-07-31 |
Last Update Date | 2025-09-26 |