| NPI | 1568703833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA 69512) |
| Additional Taxonomies | 167G00000X Licensed Psychiatric Technician (Licence: CA 19686) |
| Enumeration Date | 2013-03-11 |
| Last Update Date | 2013-03-11 |