| NPI | 1306561972 |
|---|---|
| Other Name | MEGAN KAY ELLIS VAN VLACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 134203) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA 14946) |
| Enumeration Date | 2022-10-06 |
| Last Update Date | 2024-07-31 |