NPI | 1306354428 |
---|---|
Former Name | LAUREN ELIZABETH HAM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 103807) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 103807) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: CA 103807) | |
Enumeration Date | 2018-01-11 |
Last Update Date | 2021-03-29 |