| NPI | 1861602278 |
|---|---|
| Former Name | JESSICA REILLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 0006547) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO 0006547) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2022-08-30 |