NPI | 1508182304 |
---|---|
Former Name | KANIECIA LASHEA COOPER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 94323) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF 63143) |
101YM0800X Counselor, Mental Health | |
101YM0800X Counselor, Mental Health (Licence: CA IMF 63143) | |
Enumeration Date | 2010-04-19 |
Last Update Date | 2016-09-06 |