| NPI | 1578724159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA 27906) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 103T00000X Psychologist | |
| 103TC2200X Psychologist Clinical Child & Adolescent | |
| 103TP2701X Psychologist Group Psychotherapy | |
| 103TC1900X Psychologist Counseling | |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2016-01-25 |