NPI | 1871872606 |
---|---|
Former Name | BRIANNE BALLARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 114778) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 91898) |
Enumeration Date | 2011-08-10 |
Last Update Date | 2022-08-08 |