| NPI | 1861775322 |
|---|---|
| Former Name | JESSICA ALICE KOCH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NV 7040-C) |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2018-03-17 |