| NPI | 1063604130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 45757) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: CA 45757) |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2007-08-13 |