NPI | 1952475709 |
---|---|
Former Name | JENNIFER RENEE NICHOLS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 27722) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 18034) |
Enumeration Date | 2006-11-20 |
Last Update Date | 2015-03-10 |