NPI | 1922424613 |
---|---|
Former Name | AMANDA LYNN FREEMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 96408) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
Enumeration Date | 2014-03-05 |
Last Update Date | 2023-10-16 |