| NPI | 1780910133 |
|---|---|
| Former Name | JESSICA RAE MULLICAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 12451) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2009-10-20 |
| Last Update Date | 2023-02-22 |