NPI | 1871037507 |
---|---|
Former Name | JADE CLEMONS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: KY 285440) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2016-12-14 |
Last Update Date | 2024-02-23 |