NPI | 1275071771 |
---|---|
Former Name | MALLORY WILKINSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 109864) |
Additional Taxonomies | 101Y00000X Counselor |
Enumeration Date | 2017-02-03 |
Last Update Date | 2022-12-01 |