NPI | 1285902072 |
---|---|
Former Name | KASSIE NICOLE MORENO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT104527) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF73409) |
Enumeration Date | 2011-12-07 |
Last Update Date | 2018-02-15 |