| NPI | 1265753230 |
|---|---|
| Former Name | FANTA TANAYA WASHINGTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 96064) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2010-06-14 |
| Last Update Date | 2025-07-28 |