| NPI | 1033520572 |
|---|---|
| Former Name | LISA DESTRO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT100353) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA IMF 75434) |
| Enumeration Date | 2014-05-19 |
| Last Update Date | 2019-10-03 |