| NPI | 1043578057 |
|---|---|
| Former Name | ANGELINE MARIE MIKELATOS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 98261) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 106H00000X Marriage & Family Therapist (Licence: CA 75920) | |
| Enumeration Date | 2012-04-26 |
| Last Update Date | 2017-03-01 |