| NPI | 1487193637 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA Psy34382) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 97344) |
| 103TC0700X Psychologist, Clinical (Licence: CA psb94024192) | |
| Enumeration Date | 2017-02-21 |
| Last Update Date | 2024-08-07 |