NPI | 1942554191 |
---|---|
Former Name | JESSICA RASLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: OK 7059) |
Additional Taxonomies | 101Y00000X Counselor (Licence: TN 3905) |
Enumeration Date | 2012-11-08 |
Last Update Date | 2023-08-11 |