| NPI | 1568548048 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: SD 118) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: SD LMFT 1012) |
| 106H00000X Marriage & Family Therapist (Licence: MN LMFT 212) | |
| 106H00000X Marriage & Family Therapist (Licence: CO LMFT 140) | |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2007-07-08 |