| NPI | 1063869451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CA 99290) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA ASW70243) |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2021-04-12 |