| NPI | 1972204402 |
|---|---|
| Former Name | KRISSIKA JACKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OK 8298) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2023-03-13 |
| Last Update Date | 2025-08-14 |