| NPI | 1245698372 |
|---|---|
| Other Name | HEIDI CRYSTAL LAGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 117296) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2016-02-03 |
| Last Update Date | 2021-02-06 |