| NPI | 1891977427 |
|---|---|
| Former Name | JESSICA FAYE LENZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SD LPC-MH 2217) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: SD LPC1190) |
| Enumeration Date | 2007-12-05 |
| Last Update Date | 2012-09-21 |