| NPI | 1326120916 |
|---|---|
| Former Name | TARA EILEEN KELSO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 52963) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 54570) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2021-09-15 |