NPI | 1912120403 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY20210) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFT31271) |
Enumeration Date | 2007-04-11 |
Last Update Date | 2007-07-08 |