| NPI | 1861849317 |
|---|---|
| Former Name | JESSICA KINCHELOE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2020-02763) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2016-05-14 |
| Last Update Date | 2021-06-30 |