NPI | 1669753778 |
---|---|
Former Name | DOREEN ELLENA NEUSTICE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 94480) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF61983) |
Enumeration Date | 2011-09-01 |
Last Update Date | 2016-10-17 |