| NPI | 1528333796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 52136) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 52136) |
| 101YS0200X Counselor, School (Licence: CA 52136) | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: CA 52136) | |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: CA 52136) | |
| 261QR1300X Clinic/Center, Rural Health (Licence: CA 52136) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: CA 52136) | |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2018-06-20 |