NPI | 1881001915 |
---|---|
Former Name | KELLIANNE JANAE MAHER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 105824) |
Additional Taxonomies | 101Y00000X Counselor |
Enumeration Date | 2014-07-21 |
Last Update Date | 2020-10-21 |