NPI | 1134647498 |
---|---|
Former Name | CAROLYN GARDELLA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 119360) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: 119360) |
106H00000X Marriage & Family Therapist (Licence: CA 100568) | |
Enumeration Date | 2017-09-06 |
Last Update Date | 2021-01-18 |