NPI | 1093402901 |
---|---|
Former Name | ANGELA RENEE MATHEWS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 124430) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 123340) |
Enumeration Date | 2023-04-20 |
Last Update Date | 2023-04-20 |