| NPI | 1467658963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 52054) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: Trainee) |
| 106H00000X Marriage & Family Therapist (Licence: CA 55614) | |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2012-09-06 |