| NPI | 1780418509 |
|---|---|
| Former Name | KATHLEEN DENISE CHEATHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WA MFT.LF.00001292) |
| Enumeration Date | 2024-08-26 |
| Last Update Date | 2024-08-26 |