| NPI | 1164737607 |
|---|---|
| Former Name | DESIREE TATIANNA WEATHERFORD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 78621) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 63728) |
| Enumeration Date | 2010-08-09 |
| Last Update Date | 2021-11-16 |