NPI | 1730521758 |
---|---|
Former Name | SHELBY ANN LARSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 128199) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
101YP2500X Counselor, Professional (Licence: CA 10270) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2013-07-18 |
Last Update Date | 2024-08-08 |