| NPI | 1073016036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CA 90131) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: CA 90131) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-15 |
| Last Update Date | 2021-07-20 |