| NPI | 1215496799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA 33269) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: CA 33269) | |
| Enumeration Date | 2019-03-14 |
| Last Update Date | 2022-04-27 |