| NPI | 1760779813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA 79256) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2011-07-08 |
| Last Update Date | 2018-03-17 |