| NPI | 1922672666 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 136620) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2021-05-17 |
| Last Update Date | 2024-09-30 |