NPI | 1184158982 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 34905) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 86987) |
Enumeration Date | 2017-04-18 |
Last Update Date | 2024-03-06 |