| NPI | 1982655411 |
|---|---|
| Former Name | JENNIFER ROBERTA VERRILL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 2003019630) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KS 1223) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2011-06-14 |