NPI | 1811395866 |
---|---|
Former Name | BRIANNA DOMINIQUE BELTRAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA PSY31552) |
Additional Taxonomies | 101YM0800X Counselor Mental Health |
Enumeration Date | 2014-12-08 |
Last Update Date | 2022-03-16 |