NPI | 1982064101 |
---|---|
Former Name | JESSICA S. JACKSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 6236) |
Additional Taxonomies | 104100000X Social Worker |
Enumeration Date | 2016-03-01 |
Last Update Date | 2018-12-03 |