NPI | 1992075386 |
---|---|
Former Name | DANIELLE LORI SELVIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: CA 29884) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist |
106H00000X Marriage & Family Therapist (Licence: CA 77169) | |
Enumeration Date | 2012-01-03 |
Last Update Date | 2022-05-03 |