NPI | 1104395912 |
---|---|
Former Name | ESTEFANI MEDINA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106S00000X Behavior Technician |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 123566) |
Enumeration Date | 2018-11-21 |
Last Update Date | 2025-04-16 |