| NPI | 1083498901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA Waivered) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 114337) |
| Enumeration Date | 2023-08-22 |
| Last Update Date | 2023-10-04 |