NPI | 1972955391 |
---|---|
Entity Type | Individual |
Gender | N/A |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: DE FT-0000049) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MT BBH-LMFT-LIC-32409) |
Enumeration Date | 2016-07-09 |
Last Update Date | 2023-11-28 |