NPI | 1902272990 |
---|---|
Former Name | JESSYCA NECHELLE OPP-SOBANIA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA MC6081310) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP60943211) |
Enumeration Date | 2015-08-13 |
Last Update Date | 2021-12-31 |