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 |