NPI | 1194475186 |
---|---|
Former Name | KIYANA ZACHERY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: AL A370) |
Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2022-03-24 |
Last Update Date | 2025-06-16 |