| NPI | 1114182615 |
|---|---|
| Former Name | EBONY OMAKA BEASLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT103023) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2019-04-29 |