| NPI | 1942680780 |
|---|---|
| Former Name | MONICA ELIZABETH JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 71153) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 71153) |
| Enumeration Date | 2015-06-07 |
| Last Update Date | 2022-02-14 |