NPI | 1073995221 |
---|---|
Former Name | AMANDA V TUCKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 121151) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 93188) |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2015-06-24 |
Last Update Date | 2020-09-02 |