| NPI | 1700372158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: 107466) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 99945) |
| Enumeration Date | 2018-07-09 |
| Last Update Date | 2019-05-07 |