NPI | 1427358977 |
---|---|
Former Name | MEREDITH GORDON MACY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NC 1616) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC 9211) |
Enumeration Date | 2010-11-01 |
Last Update Date | 2016-12-12 |