| NPI | 1134540362 |
|---|---|
| Former Name | RAVEN ROYAL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 134483) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 109H00000X) |
| 106H00000X Marriage & Family Therapist (Licence: CA 109237) | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2013-12-13 |
| Last Update Date | 2022-09-06 |