NPI | 1417464967 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT110222) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF75648) |
261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: CA 300049AP) | |
Enumeration Date | 2018-01-05 |
Last Update Date | 2019-08-13 |