NPI | 1952857435 |
---|---|
Former Name | MARISSA B HOMBURG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 94199) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: OR T2530) |
106H00000X Marriage & Family Therapist (Licence: ID LMFT-8351) | |
Enumeration Date | 2016-08-25 |
Last Update Date | 2025-01-09 |