NPI | 1891043865 |
---|---|
Former Name | JENNA I WASHINGTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 30486) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
225C00000X Rehabilitation Counselor | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2012-08-24 |
Last Update Date | 2020-04-21 |