NPI | 1841700606 |
---|---|
Former Name | JESSICA GARRETT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401020335) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH C.1902252) |
101YP2500X Counselor, Professional (Licence: MI 6401020335) | |
Enumeration Date | 2017-10-06 |
Last Update Date | 2023-04-14 |