| NPI | 1093422750 |
|---|---|
| Former Name | STACEY CHONG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT134560) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA APCC12282) |
| Enumeration Date | 2022-11-02 |
| Last Update Date | 2022-11-02 |