NPI | 1750694428 |
---|---|
Former Name | MARISSA LEIGH DESANTI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 0011471) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist |
Enumeration Date | 2010-07-22 |
Last Update Date | 2015-02-24 |