NPI | 1982177762 |
---|---|
Former Name | LORI MATTINGLY BOYD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 139097) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 106316) |
Enumeration Date | 2019-01-04 |
Last Update Date | 2023-04-21 |