| NPI | 1881148666 |
|---|---|
| Former Name | JACQUELINE BRANDY MCCOY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IN 35002029A) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN 87001621A) |
| Enumeration Date | 2016-08-09 |
| Last Update Date | 2024-06-18 |