NPI | 1164041430 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT125853) |
Additional Taxonomies | 101Y00000X Counselor (Licence: CA AMFT115385) |
101YM0800X Counselor, Mental Health (Licence: CA LMFT125853) | |
Enumeration Date | 2020-04-15 |
Last Update Date | 2023-09-19 |