| NPI | 1215279963 |
|---|---|
| Former Name | KELLY FLAVIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA IMF66109) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 1-11-8061) |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2024-11-06 |