| NPI | 1023302569 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW113299)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA LCi1281018)  | 
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2011-06-01 | 
| Last Update Date | 2023-02-21 |