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 |