| NPI | 1982009320 |
|---|---|
| Former Name | JESSICA JEANNE SHAFER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C7066) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR R5085) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2014-10-28 |
| Last Update Date | 2024-05-10 |