| NPI | 1346643244 |
|---|---|
| Former Name | VICTORIA BRODERSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IA 091593) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IA 091593) |
| Enumeration Date | 2014-10-06 |
| Last Update Date | 2022-06-12 |