| NPI | 1720590730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 135625) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA 116127) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-10-31 |
| Last Update Date | 2022-11-02 |