| NPI | 1104188168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CA 80744) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 80744) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2025-08-12 |