NPI | 1699195693 |
---|---|
Former Name | REBECCA LYNNE BEALL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WI 1000-124) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 2582) |
Enumeration Date | 2014-04-17 |
Last Update Date | 2020-01-09 |