| NPI | 1770695165 |
|---|---|
| Former Name | JINNIE DEANNE MARTINUSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 43514) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 413808MFTIntern) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2012-12-11 |