| NPI | 1992916696 |
|---|---|
| Former Name | JACQUELINE CODERRE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0704015932) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024167578) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2025-07-20 |