| NPI | 1124540497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA PSB94023267) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CA 167373V) |
| Enumeration Date | 2017-07-08 |
| Last Update Date | 2018-06-16 |