| NPI | 1770753857 |
|---|---|
| Former Name | JENNIFER KATHLEEN BENNETT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MO 2011031531) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA 23217) |
| Enumeration Date | 2008-03-05 |
| Last Update Date | 2020-12-21 |