| NPI | 1881657534 |
|---|---|
| Former Name | JESSICA GILDEHAUS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2004014923) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MO 2004014923) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2023-08-24 |