| NPI | 1952666331 |
|---|---|
| Former Name | JAVEN VALERIE FERMO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: TX P5047) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NY 265376) |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2020-11-23 |