NPI | 1558612440 |
---|---|
Former Name | CAMILLA BECKSTEAD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CO MFT.0001430) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: KY 2012-024) |
Enumeration Date | 2012-10-02 |
Last Update Date | 2020-06-29 |