| NPI | 1770153058 |
|---|---|
| Former Name | JENNA MARIE CONNOLLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA G164270) |
| Enumeration Date | 2021-06-29 |
| Last Update Date | 2021-06-29 |