NPI | 1952833147 |
---|---|
Former Name | ALEXIS NICOLE GRENNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 113859) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
101YP2500X Counselor, Professional | |
Enumeration Date | 2017-03-28 |
Last Update Date | 2019-06-17 |