NPI | 1770935249 |
---|---|
Former Name | EVELYN ROSE VELASCO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 110962) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA 4359) |
Enumeration Date | 2016-07-08 |
Last Update Date | 2019-04-03 |