| NPI | 1871989830 |
|---|---|
| Former Name | JESSICA CHAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: OR 1-15-18041) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR C3570) |
| 103K00000X Behavior Analyst | |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2022-06-07 |