NPI | 1003555426 |
---|---|
Former Name | ALEXANDRA LOUISE KING |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 137606) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 137606) |
Enumeration Date | 2022-06-02 |
Last Update Date | 2023-05-09 |