| NPI | 1265683486 |
|---|---|
| Former Name | SUSAN ANNETTE STEVENSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC45114) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CA ASSOCIATES DEGREE) |
| Enumeration Date | 2008-10-07 |
| Last Update Date | 2008-10-07 |