| NPI | 1780559153 |
|---|---|
| Former Name | JENNIFER NACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: PA PS020605) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS020605) |
| Enumeration Date | 2025-10-07 |
| Last Update Date | 2025-10-07 |