| NPI | 1750876926 |
|---|---|
| Former Name | JUSTINE MARIE CHACON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 103737) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2018-06-28 |
| Last Update Date | 2021-04-20 |