NPI | 1750733093 |
---|---|
Former Name | JESSICA SWINFORD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L8627) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2016-07-11 |
Last Update Date | 2021-10-22 |