NPI | 1982364840 |
---|---|
Former Name | JAMIE MARIE MAHONEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IL 166.001728) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: AR F2408002) |
106H00000X Marriage & Family Therapist (Licence: IN 35002424A) | |
Enumeration Date | 2021-12-20 |
Last Update Date | 2025-09-08 |