| NPI | 1962584458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY 18673) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA LCS 4475) |
| 106H00000X Marriage & Family Therapist (Licence: CA MFC 14048) | |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2007-07-08 |