| NPI | 1750782702 |
|---|---|
| Former Name | JESSICA L. WAKELING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ME CC4820) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME CAC4355) |
| Enumeration Date | 2014-09-09 |
| Last Update Date | 2017-05-09 |