NPI | 1023203320 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: AZ 15266) |
Additional Taxonomies | 101YM0800X Counselor Mental Health |
106H00000X Marriage & Family Therapist (Licence: CA 53680) | |
261QM0850X Clinic/Center Adult Mental Health | |
Enumeration Date | 2007-09-10 |
Last Update Date | 2021-01-14 |