NPI | 1568799849 |
---|---|
Former Name | WILLOW PEARSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: CA 29436) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 50993) |
Enumeration Date | 2009-11-08 |
Last Update Date | 2024-08-27 |