NPI | 1386175842 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA IMF75645) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 112816 IV) |
Enumeration Date | 2017-03-24 |
Last Update Date | 2017-03-24 |