| NPI | 1063972602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 145797) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2024-04-17 |