| NPI | 1902677982 |
|---|---|
| Former Name | JACQUELINE WARREN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OH C.2506732) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH C.2305318-TRNE) |
| Enumeration Date | 2024-01-10 |
| Last Update Date | 2025-01-31 |