NPI | 1639283617 |
---|---|
Former Name | SUSAN RAE RYAVE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFT31659) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist |
106H00000X Marriage & Family Therapist (Licence: CA MFC31659) | |
Enumeration Date | 2006-08-18 |
Last Update Date | 2021-05-17 |