NPI | 1760058572 |
---|---|
Former Name | JENNIFER DARGAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: MO 2020036387) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MO 2013022746) |
Enumeration Date | 2021-06-02 |
Last Update Date | 2021-09-16 |