| NPI | 1609231711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 95040) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: CA 95040) |
| Enumeration Date | 2015-12-17 |
| Last Update Date | 2020-03-14 |