| NPI | 1811055882 |
|---|---|
| Former Name | LAURA SUZANNE JENINGS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 222Q00000X Developmental Therapist |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL 811601600) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2012-10-31 |