NPI | 1053798868 |
---|---|
Former Name | JODIE ELIZABETH LAM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 113965) |
Additional Taxonomies | 101Y00000X Counselor |
Enumeration Date | 2015-04-30 |
Last Update Date | 2021-08-23 |