| NPI | 1851609531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY 26259) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IL 180.006807) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-09-16 |
| Last Update Date | 2014-03-13 |