| 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 |