NPI | 1164654323 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 31636) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2009-08-20 |
Last Update Date | 2020-09-27 |