NPI | 1629387238 |
---|---|
Former Name | ELLEN CLAIRE VANDENBERG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA IMF 71389) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist |
Enumeration Date | 2010-09-29 |
Last Update Date | 2019-05-28 |