NPI | 1902299811 |
---|---|
Former Name | JENNIFER NICOLE WALLACE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 170300000X Genetic Counselor, MS (Licence: CA GC000646) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2015-03-17 |
Last Update Date | 2022-10-06 |