NPI | 1578857801 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-04-2053) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 48029) |
Enumeration Date | 2011-06-03 |
Last Update Date | 2017-03-23 |