NPI | 1508117045 |
---|---|
Former Name | KIRSTEN NICOLE EBERLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-14-10192) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 106536) |
Enumeration Date | 2012-09-24 |
Last Update Date | 2023-01-12 |