| NPI | 1619071909 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: AZ LPC1262) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MP19615) |
| Enumeration Date | 2006-09-08 |
| Last Update Date | 2009-05-05 |