NPI | 1366032542 |
---|---|
Former Name | MEREDITH LYNNE RIDGELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: GA MFT002081) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA AMFT121322) |
Enumeration Date | 2021-01-21 |
Last Update Date | 2024-01-02 |