| 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 |