NPI | 1124532601 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: FL IMT-4000) |
Additional Taxonomies | 103T00000X Psychologist (Licence: PR 5928) |
103T00000X Psychologist (Licence: FL TPPY-152) | |
Enumeration Date | 2017-11-20 |
Last Update Date | 2023-11-09 |