NPI | 1184836330 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY 22519) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 30679) |
Enumeration Date | 2007-05-03 |
Last Update Date | 2012-07-07 |