NPI | 1861890717 |
---|---|
Former Name | KATELYN ELIZABETH LILLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 101322) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF78876) |
Enumeration Date | 2014-12-09 |
Last Update Date | 2023-01-05 |