NPI | 1194064154 |
---|---|
Former Name | ANASTACIA DELVALLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: GA MFT001385) |
Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: GA AMFT000231) |
Enumeration Date | 2013-02-11 |
Last Update Date | 2023-09-13 |