| NPI | 1780247981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 130501) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-04-15 |
| Last Update Date | 2022-01-21 |