| 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 |