NPI | 1245874429 |
---|---|
Former Name | LOREN VACKO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 128696) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist |
Enumeration Date | 2019-10-31 |
Last Update Date | 2021-11-11 |