NPI | 1164876785 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY10109) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFT22933) |
Enumeration Date | 2016-04-20 |
Last Update Date | 2016-04-20 |