| NPI | 1881246403 |
|---|---|
| Former Name | AMANDA KIMBERLEY LOPEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 114377) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: AZ LMFT15786) |
| Enumeration Date | 2019-07-13 |
| Last Update Date | 2026-06-17 |