| NPI | 1982479044 |
|---|---|
| Former Name | JESSICA EMILY DEAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR T-23-3272) |
| Enumeration Date | 2023-11-20 |
| Last Update Date | 2023-11-20 |