NPI | 1023367604 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY34814) |
Additional Taxonomies | 101Y00000X Counselor |
101YM0800X Counselor, Mental Health | |
101YM0800X Counselor, Mental Health (Licence: CA PSB94025247) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2012-08-29 |
Last Update Date | 2025-01-01 |