| NPI | 1821209412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA PSY 16945) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFT 35865) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2007-07-08 |