| NPI | 1104342971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CA 97272) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2017-08-14 |
| Last Update Date | 2021-01-15 |