NPI | 1861961435 |
---|---|
Former Name | SONJA MARIE BERTRAM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: ID LCPC-10273) |
Additional Taxonomies | 101Y00000X Counselor (Licence: WA MC60597315) |
101YM0800X Counselor, Mental Health (Licence: WA LH60938904) | |
106H00000X Marriage & Family Therapist (Licence: WA MG60597313) | |
Enumeration Date | 2018-11-13 |
Last Update Date | 2024-03-15 |