| NPI | 1972142263 |
|---|---|
| Former Name | JESSICA V REYES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 9812) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 9812-33) |
| Enumeration Date | 2020-01-03 |
| Last Update Date | 2021-01-28 |