NPI | 1104226257 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW94228) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA ASW71877) |
Enumeration Date | 2014-08-26 |
Last Update Date | 2020-05-18 |