| NPI | 1548794159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA LEP2387) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA LPCC3814) |
| 101YP2500X Counselor Professional (Licence: CA LPCC3814) | |
| Enumeration Date | 2017-04-20 |
| Last Update Date | 2017-04-20 |