NPI | 1629271325 |
---|---|
Former Name | JACQUELINE ALICE SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 48253) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF47159) |
Enumeration Date | 2007-06-08 |
Last Update Date | 2024-05-28 |