| NPI | 1578860987 |
|---|---|
| Former Name | KRYSTAL JANELLE CLARKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: FL 3685) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: UT 12894552-3902) |
| 106H00000X Marriage & Family Therapist (Licence: GA MFT001949) | |
| 106H00000X Marriage & Family Therapist (Licence: CA 97088) | |
| Enumeration Date | 2011-02-21 |
| Last Update Date | 2022-09-22 |