| NPI | 1346898442 |
|---|---|
| Former Name | AMANDA MICHELE COLLIATIE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CO MFT.0002097) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: KS 3074) |
| Enumeration Date | 2019-09-01 |
| Last Update Date | 2022-05-12 |