| NPI | 1326719618 |
|---|---|
| Former Name | BRANDY LORRAINE CANNON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 126661) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA 9868) |
| Enumeration Date | 2021-09-25 |
| Last Update Date | 2021-09-25 |