NPI | 1184102014 |
---|---|
Former Name | CHRISTINA KATHLEEN BASS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 112942) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA AMFT87820) |
Enumeration Date | 2018-08-02 |
Last Update Date | 2021-05-14 |