| NPI | 1114644549 |
|---|---|
| Former Name | AMANDA JEAN TIMMERMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 143632) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 8183) |
| Enumeration Date | 2022-10-26 |
| Last Update Date | 2024-08-02 |