NPI | 1114113586 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC 40995) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA MFC40995) |
Enumeration Date | 2007-09-19 |
Last Update Date | 2012-08-06 |