| NPI | 1003153768 |
|---|---|
| Former Name | CONSTANCE BRAVOS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OR T1607) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2013-01-14 |
| Last Update Date | 2023-12-15 |