| NPI | 1851610646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 102L00000X Psychoanalyst (Licence: CA MFT29762) |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility (Licence: CA MFT29762) |
| 106H00000X Marriage & Family Therapist (Licence: CA MFT29762) | |
| Enumeration Date | 2010-05-19 |
| Last Update Date | 2010-09-30 |