| NPI | 1841600319 |
|---|---|
| Former Name | JACQUELINE JEFFRIES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LISAC-11894) |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2014-09-10 |