| NPI | 1851497879 |
|---|---|
| Former Name | VIRGINIA JACOBS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP1355) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 680) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2023-12-13 |