NPI | 1770720088 |
---|---|
Former Name | JENNIFER L STREETS WOOD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 001200) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180007076) |
Enumeration Date | 2009-01-09 |
Last Update Date | 2021-02-22 |