| NPI | 1205989399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA PSY23503) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA PSY23503) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: CA PSY23503) | |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: CA PSY23503) | |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2010-10-14 |