NPI | 1194305318 |
---|---|
Former Name | ALEXA V PETERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WI 2004) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WI 780-228) |
Enumeration Date | 2021-04-12 |
Last Update Date | 2023-11-30 |