NPI | 1225896194 |
---|---|
Former Name | ELIZABETH VICTORIA BOZE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 125523) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 9528) |
106H00000X Marriage & Family Therapist (Licence: TX 205401) | |
Enumeration Date | 2024-03-06 |
Last Update Date | 2024-03-06 |