| NPI | 1104302017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW100937) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 83450ACSW) |
| Enumeration Date | 2018-07-13 |
| Last Update Date | 2021-06-02 |