| NPI | 1770981185 |
|---|---|
| Former Name | JENNIFER MICHELLE NELSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904016419) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: 00107972) |
| 104100000X Social Worker (Licence: NY 92417) | |
| 1041C0700X Social Worker, Clinical (Licence: NY 087515-01) | |
| Enumeration Date | 2014-12-17 |
| Last Update Date | 2024-12-28 |