| NPI | 1295029114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: CA 94024296) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CA 94024296) |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2021-03-23 |