NPI | 1063990539 |
---|---|
Former Name | JENELLE ANGELINA GREIG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 95613) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA 3379) |
Enumeration Date | 2018-08-06 |
Last Update Date | 2024-06-10 |