| NPI | 1669592739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 104667) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA Student Intern) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA MFT TRAINEE) | |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2021-11-03 |