NPI | 1962923698 |
---|---|
Former Name | IVETTE VILLANUEVA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 122925) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 97984) |
106S00000X Behavior Technician | |
Enumeration Date | 2017-07-03 |
Last Update Date | 2024-06-13 |