| NPI | 1881242691 |
|---|---|
| Former Name | JESSICA MARIE PALOUCEK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NE 1082) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KS T-LMLP2938) |
| Enumeration Date | 2019-08-27 |
| Last Update Date | 2023-08-09 |