| NPI | 1053901769 |
|---|---|
| Former Name | AIDA TAVAREZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA 112875) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CA ASW112875) |
| 1041C0700X Social Worker, Clinical (Licence: CA ACSW112875) | |
| Enumeration Date | 2021-01-26 |
| Last Update Date | 2026-02-11 |