| NPI | 1255445722 |
|---|---|
| Former Name | DIANNA MARIE BACA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT78625) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA imf00046949) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2015-05-06 |