| NPI | 1033466230 |
|---|---|
| Former Name | EBONY CHANTAL CASTLEBERRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 93244) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 76691) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-08-07 |
| Last Update Date | 2021-11-11 |