NPI | 1801302633 |
---|---|
Former Name | OCTAVIA GAVRILA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 4612) |
Additional Taxonomies | 103TF0000X Psychologist, Family (Licence: CA LMFT94660) |
Enumeration Date | 2017-12-15 |
Last Update Date | 2017-12-15 |