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 |