| NPI | 1912384363 |
|---|---|
| Former Name | JESSENA JOHNYKUTTY SAMUEL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2015-05-05 |
| Last Update Date | 2018-01-13 |