| NPI | 1518636448 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 107230)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 5229)  | 
| Enumeration Date | 2021-09-13 | 
| Last Update Date | 2021-09-13 |