NPI | 1891075081 |
---|---|
Former Name | DENESE WALERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: GA 001208) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: GA 000196) |
Enumeration Date | 2011-08-19 |
Last Update Date | 2020-12-03 |