| NPI | 1518515477 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 122122) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA 122122) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-09-03 |
| Last Update Date | 2021-11-29 |