| NPI | 1720100316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 45958) |
| Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: CA 45958) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2011-05-19 |