| NPI | 1962530501 |
|---|---|
| Former Name | JESSICA MARIE LEROY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LF60368007) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR T0962) |
| 106H00000X Marriage & Family Therapist (Licence: CA MFI30015) | |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2021-05-23 |