NPI | 1043349228 |
---|---|
Former Name | MELISSA BALLOU |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 135640) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2007-03-05 |
Last Update Date | 2024-03-26 |