NPI | 1326376617 |
---|---|
Former Name | LISA ANN VANDENRAADT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 105746) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFT 62190) |
Enumeration Date | 2009-11-24 |
Last Update Date | 2023-04-25 |