| NPI | 1871718759 | 
|---|---|
| Former Name | BETHANY RAINAUD | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA Psy 22581) | 
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFT41649) | 
| Enumeration Date | 2007-04-16 | 
| Last Update Date | 2012-07-11 |