NPI | 1376005041 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 135152) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 6362) |
106S00000X Behavior Technician | |
Enumeration Date | 2019-04-02 |
Last Update Date | 2024-09-03 |