NPI | 1992076731 |
---|---|
Former Name | JESSICA MARIE WEST |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 90878) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 90878) |
Enumeration Date | 2012-01-25 |
Last Update Date | 2021-10-15 |