| 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 |