NPI | 1073679122 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA MFT 15138) |
Additional Taxonomies | 103T00000X Psychologist (Licence: CA LEP1500) |
Enumeration Date | 2006-12-30 |
Last Update Date | 2007-07-08 |