| NPI | 1033701552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA WAIVERED) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 261QM0850X Clinic/Center Adult Mental Health | |
| Enumeration Date | 2021-02-05 |
| Last Update Date | 2023-09-21 |