| NPI | 1396899050 |
|---|---|
| Former Name | STACIE BRYANT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 47670) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CO MFT-893) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2022-03-09 |