NPI | 1154875730 |
---|---|
Former Name | CRYSTAL SHOHATEE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 109370) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
106H00000X Marriage & Family Therapist (Licence: CA 93727) | |
Enumeration Date | 2016-08-11 |
Last Update Date | 2022-07-21 |