| NPI | 1104343128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CA 120119) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA 89191) |
| Enumeration Date | 2017-08-30 |
| Last Update Date | 2025-08-15 |