| NPI | 1003211764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CA 99435) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA ASW61888) |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2021-01-15 |