| NPI | 1861770810 |
|---|---|
| Former Name | JESSICA RUSH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 64553) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VA 0701010702) |
| Enumeration Date | 2011-07-25 |
| Last Update Date | 2021-09-02 |