NPI | 1700368974 |
---|---|
Former Name | LAUREN ELLIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 112843) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 94773) |
Enumeration Date | 2018-09-04 |
Last Update Date | 2023-07-12 |