| NPI | 1831536812 |
|---|---|
| Former Name | JENNIE ALEXA DAWN MARTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: OK 1400) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OK 7120) |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2022-05-19 |