NPI | 1306063821 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY 21395) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA LMFT 35910) |
163W00000X Registered Nurse (Licence: CA RN 401587) | |
Enumeration Date | 2007-04-19 |
Last Update Date | 2007-07-08 |