| NPI | 1912419607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 115869) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 9298) |
| 101YM0800X Counselor, Mental Health (Licence: CA 118569) | |
| Enumeration Date | 2017-11-02 |
| Last Update Date | 2021-01-11 |