| NPI | 1063867208 |
|---|---|
| Former Name | CARRIE DIETZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT114924) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF83555) |
| 103K00000X Behavior Analyst | |
| Enumeration Date | 2016-04-25 |
| Last Update Date | 2022-07-21 |