| NPI | 1104975911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC42697) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: BCBA 1-13-12958) |
| 101Y00000X Counselor (Licence: CA LPCC 1526) | |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2015-04-10 |