| NPI | 1962034116 |
|---|---|
| Former Name | JUANITA JACQUELINE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 81411) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 180.009715) |
| 101YM0800X Counselor, Mental Health (Licence: CA 9225) | |
| Enumeration Date | 2020-02-05 |
| Last Update Date | 2025-10-10 |