| NPI | 1154961605 |
|---|---|
| Former Name | CHANTIA NICOLE JUSTICE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 122661) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 111034) |
| Enumeration Date | 2020-01-13 |
| Last Update Date | 2021-09-28 |