NPI | 1689051807 |
---|---|
Former Name | AMBER FREEMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC012258) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA 6246) |
106H00000X Marriage & Family Therapist (Licence: CA 114675) | |
Enumeration Date | 2015-04-27 |
Last Update Date | 2023-09-24 |