| NPI | 1831812106 |
|---|---|
| Former Name | JESSICA LYN BAKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WV 3071) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: PA 1371534) |
| Enumeration Date | 2022-09-22 |
| Last Update Date | 2025-03-18 |