| NPI | 1912510157 |
|---|---|
| Former Name | JESSICA DEAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: GA PSY004615) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2020-08-27 |
| Last Update Date | 2022-07-27 |