NPI | 1154758753 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT 84728) |
Additional Taxonomies | 101Y00000X Counselor (Licence: CA IMF 65210) |
101YM0800X Counselor Mental Health (Licence: CA IMF 65210) | |
Enumeration Date | 2013-09-27 |
Last Update Date | 2015-03-05 |