NPI | 1568538825 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 25047) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 46358) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA RA855007) | |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA lr300411) | |
Enumeration Date | 2006-11-28 |
Last Update Date | 2015-10-29 |