NPI | 1841641479 |
---|---|
Former Name | JESSICA HARMON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NM CCMH0222881) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NM CMH0202951) |
106S00000X Behavior Technician | |
Enumeration Date | 2016-06-24 |
Last Update Date | 2022-02-17 |