| NPI | 1932559614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA LMFT 50894) |
| Additional Taxonomies | 103TH0004X Psychologist Health (Licence: CA LMFT 50894) |
| 103TH0100X Psychologist Health Service (Licence: CA LMFT 50894) | |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2016-06-14 |