NPI | 1174990063 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 33674) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2015-08-26 |
Last Update Date | 2024-08-16 |