| NPI | 1770099293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 110201) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-15-01645) |
| Enumeration Date | 2017-12-19 |
| Last Update Date | 2018-12-12 |