| NPI | 1528602828 |
|---|---|
| Former Name | DAMARIS ELLEN KELLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFT33016) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: ID MFT6947) |
| Enumeration Date | 2019-10-30 |
| Last Update Date | 2019-10-30 |