| NPI | 1336873850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA 35768) |
| Additional Taxonomies | 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: CA 35768) |
| 103TC1900X Psychologist Counseling (Licence: CA 35768) | |
| 103TH0004X Psychologist Health (Licence: CA 35768) | |
| 103TH0100X Psychologist Health Service (Licence: CA 35768) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: CA 35768) | |
| Enumeration Date | 2022-07-11 |
| Last Update Date | 2025-03-31 |