| NPI | 1487967451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: CA 59256) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA LMFT87990) |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2021-01-28 |