| NPI | 1548802069 |
|---|---|
| Former Name | JACQUELINE GALLEGOS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 133435) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 115256) |
| Enumeration Date | 2019-10-16 |
| Last Update Date | 2022-08-16 |