NPI | 1720772916 |
---|---|
Former Name | REBECCA BISHOP WAYNE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 153573) |
Additional Taxonomies | 101Y00000X Counselor (Licence: CA 18922) |
Enumeration Date | 2023-06-08 |
Last Update Date | 2025-04-17 |