| NPI | 1871037507 |
|---|---|
| Former Name | JADE CLEMONS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TC1900X Psychologist, Counseling (Licence: KY 285440) | |
| Enumeration Date | 2016-12-14 |
| Last Update Date | 2024-06-28 |