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 |