| NPI | 1962023770 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 152379) | 
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 129266) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-05-04 | 
| Last Update Date | 2025-08-21 |