NPI | 1588170369 |
---|---|
Former Name | KRISTEN LEE GRAY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OR T1875) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 100648) |
Enumeration Date | 2017-12-16 |
Last Update Date | 2022-02-18 |