NPI | 1316102064 |
---|---|
Former Name | GINGER L LAVENDER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 57286) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 51578) |
Enumeration Date | 2008-07-22 |
Last Update Date | 2023-08-08 |