| 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 |