NPI | 1497279129 |
---|---|
Former Name | MADONNA MOBLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 124660) |
Additional Taxonomies | 101Y00000X Counselor |
106H00000X Marriage & Family Therapist (Licence: CA IMF99381) | |
Enumeration Date | 2017-08-03 |
Last Update Date | 2021-05-06 |