| NPI | 1275790602 |
|---|---|
| Former Name | LISA MARIE BRANDT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA 30725) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2019-04-04 |