| NPI | 1962555268 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA Psy24060) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA L.M.F.T. 28778) | 
| Enumeration Date | 2007-01-19 | 
| Last Update Date | 2016-10-24 |