NPI | 1720410475 |
---|---|
Former Name | MARY SULLIVAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CO MFT.0001310) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: HI LMFT-351) |
Enumeration Date | 2013-08-05 |
Last Update Date | 2024-09-19 |