| NPI | 1063999209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 107288) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 101Y00000X Counselor (Licence: CA 90359) | |
| Enumeration Date | 2018-07-20 |
| Last Update Date | 2022-08-08 |