NPI | 1154896314 |
---|---|
Former Name | AMANDA BULAT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: ND 2018-067) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 3687) |
Enumeration Date | 2018-10-03 |
Last Update Date | 2023-05-16 |