| NPI | 1407054273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 46148) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA DO706280833) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2009-12-28 |