| NPI | 1922012426 |
|---|---|
| Former Name | JENNIFER LYNNE ETCHEVERRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CO 561) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CO 561) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2018-10-19 |