| NPI | 1225063621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA LCSW14503) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: CA LCSW14503) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2023-08-02 |