NPI | 1235383365 |
---|---|
Former Name | BRENNA J BENNETT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: RI 00164) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MA 1512) |
Enumeration Date | 2008-11-17 |
Last Update Date | 2022-08-18 |