NPI | 1982957502 |
---|---|
Former Name | RACHAEL FARRYN SHANBROM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 138618) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Enumeration Date | 2012-10-19 |
Last Update Date | 2024-09-18 |