| NPI | 1104229640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW85514) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA ASW66816) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-09-29 |
| Last Update Date | 2018-09-14 |