| NPI | 1821511338 |
|---|---|
| Former Name | JENA RACHEL GORDON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: RI PS02249) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA psy10000133) |
| Enumeration Date | 2017-07-18 |
| Last Update Date | 2024-03-18 |