| NPI | 1598136053 |
|---|---|
| Former Name | EMILY J GANNON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IL 166.001311) |
| Additional Taxonomies | 101Y00000X Counselor |
| 106H00000X Marriage & Family Therapist (Licence: WY LMFT-218) | |
| 106H00000X Marriage & Family Therapist (Licence: WY PMFT-279) | |
| 106H00000X Marriage & Family Therapist (Licence: CO MFT.0001569) | |
| Enumeration Date | 2015-10-09 |
| Last Update Date | 2019-11-14 |