NPI | 1629355672 |
---|---|
Former Name | MIRANDA REDDICK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NC 2348) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NC 7079A) |
Enumeration Date | 2011-11-04 |
Last Update Date | 2022-10-03 |