NPI | 1750750683 |
---|---|
Former Name | JENNA WHITEFOOT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401014880) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6401014880) |
Enumeration Date | 2015-09-22 |
Last Update Date | 2025-05-29 |