| NPI | 1639614043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 120130) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA 107609) |
| 103K00000X Behavior Analyst (Licence: CA 1-19-37445) | |
| Enumeration Date | 2016-12-21 |
| Last Update Date | 2021-08-13 |