| NPI | 1003256280 |
|---|---|
| Former Name | KAITLYN W PERCIVAL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW76285) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA ASW37076) |
| 101YM0800X Counselor, Mental Health (Licence: CA ASW #37076) | |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2021-07-30 |