NPI | 1053777268 |
---|---|
Former Name | MOLLY MAE MARTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA LPCC5397) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2016-01-05 |
Last Update Date | 2019-08-19 |