NPI | 1730613985 |
---|---|
Former Name | AUDREY HERNANDEZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 121803) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 97664) |
Enumeration Date | 2017-04-14 |
Last Update Date | 2025-08-04 |